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Jarumethitanont W, Manupibul U, Tanthuwapathom R, Prasertsukdee S, Limroongreungrat W, Charoensuk W. Development of low-cost pressure mapping device to evaluate force distribution for seat cushion modification. Sci Rep 2024; 14:21804. [PMID: 39294267 PMCID: PMC11410948 DOI: 10.1038/s41598-024-72471-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 09/09/2024] [Indexed: 09/20/2024] Open
Abstract
This study aimed to determine the reliability and concurrent validity of a low-cost pressure mapping system (Smart mat) and reference standard pressure mapping (MatScan). Thirty healthy volunteers aged 29.57 ± 4.50 years who could sit still for at least one minute and had a hip width of less than 40 cm (36 ± 2.05 cm) were recruited. The participants sat on the Smart mat system and MatScan for 60 s per trial for 3 trials. The reliability of Smart mat using intraclass correlation coefficients (ICC) showed an excellent ICC of normalised total force (nTF) and normalised ischial width (nIW) in sitting (0.93, 0.98). The validity was assessed using Spearman correlation coefficients, which showed that nTF in sitting had a significantly strong correlation (r = 0.70**) and nIW in sitting had a significantly moderate correlation (r = 0.67**). This study's satisfactory results indicated that a low-cost pressure mapping system could be used for assessing forced distribution and ischial width during sitting.
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Affiliation(s)
- Wimonrat Jarumethitanont
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Phuttamonthon, Nakhon Pathom, Thailand
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Udomporn Manupibul
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ratikanlaya Tanthuwapathom
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Phuttamonthon, Nakhon Pathom, Thailand
| | | | | | - Warakorn Charoensuk
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Phuttamonthon, Nakhon Pathom, Thailand.
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2
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Zappalá S, Keenan BE, Marshall D, Wu J, Evans SL, Al-Dirini RMA. In vivo strain measurements in the human buttock during sitting using MR-based digital volume correlation. J Biomech 2024; 163:111913. [PMID: 38181575 DOI: 10.1016/j.jbiomech.2023.111913] [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: 05/24/2023] [Revised: 10/11/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
Advancements in systems for prevention and management of pressure ulcers require a more detailed understanding of the complex response of soft tissues to compressive loads. This study aimed at quantifying the progressive deformation of the buttock based on 3D measurements of soft tissue displacements from MR scans of 10 healthy subjects in a semi-recumbent position. Measurements were obtained using digital volume correlation (DVC) and released as a public dataset. A first parametric optimisation of the global registration step aimed at aligning skeletal elements showed acceptable values of Dice coefficient (around 80%). A second parametric optimisation on the deformable registration method showed errors of 0.99mm and 1.78mm against two simulated fields with magnitude 7.30±3.15mm and 19.37±9.58mm, respectively, generated with a finite element model of the buttock under sitting loads. Measurements allowed the quantification of the slide of the gluteus maximus away from the ischial tuberosity (IT, average 13.74 mm) that was only qualitatively identified in the literature, highlighting the importance of the ischial bursa in allowing sliding. Spatial evolution of the maximus shear strain on a path from the IT to the seating interface showed a peak of compression in the fat, close to the interface with the muscle. Obtained peak values were above the proposed damage threshold in the literature. Results in the study showed the complexity of the deformation of the soft tissues in the buttock and the need for further investigations aimed at isolating factors such as tissue geometry, duration and extent of load, sitting posture and tissue properties.
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Affiliation(s)
- Stefano Zappalá
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK.
| | | | - David Marshall
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK
| | - Jing Wu
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK
| | - Sam L Evans
- School of Engineering, Cardiff University, Cardiff, UK
| | - Rami M A Al-Dirini
- College of Science and Engineering, Flinders University of South Australia, Adelaide, Australia
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Liu S, Beillas P, Ding L, Wang X. PIPER adult comfort: an open-source full body human body model for seating comfort assessment and its validation under static loading conditions. Front Bioeng Biotechnol 2023; 11:1170768. [PMID: 37324425 PMCID: PMC10267746 DOI: 10.3389/fbioe.2023.1170768] [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: 02/21/2023] [Accepted: 05/05/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction: In this paper we introduce an adult-sized FE full-body HBM for seating comfort assessments and present its validation in different static seating conditions in terms of pressure distribution and contact forces. Methods: We morphed the PIPER Child model into a male adult-sized model with the help of different target sources including his body surface scans, and spinal and pelvic bone surfaces and an open sourced full body skeleton. We also introduced soft tissue sliding under the ischial tuberosities (ITs). The initial model was adapted for seating applications with low modulus soft tissue material property and mesh refinements for buttock regions, etc. We compared the contact forces and pressure-related parameters simulated using the adult HBM with those obtained experimentally from the person whose data was used for the model development. Four seat configurations, with the seat pan angle varying from 0° to 15° and seat-to-back angle fixed at 100°, were tested. Results: The adult HBM could correctly simulate the contact forces on the backrest, seat pan, and foot support with an average error of less than 22.3 N and 15.5 N in the horizontal and vertical directions, which is small considering the body weight (785 N). In terms of contact area, peak, and mean pressure, the simulation matched well with the experiment for the seat pan. With soft tissue sliding, higher soft tissue compression was obtained in agreement with the observations from recent MRI studies. Discussion: The present adult model could be used as a reference using a morphing tool as proposed in PIPER. The model will be published openly online as part of the PIPER open-source project (www.PIPER-project.org) to facilitate its reuse and improvement as well as its specific adaptation for different applications.
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Affiliation(s)
- Shenghui Liu
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Université de Lyon, Université Claude Bernard Lyon 1, Université Gustave Eiffel, LBMC UMR_T 9406, Lyon, France
| | - Philippe Beillas
- Université de Lyon, Université Claude Bernard Lyon 1, Université Gustave Eiffel, LBMC UMR_T 9406, Lyon, France
| | - Li Ding
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xuguang Wang
- Université de Lyon, Université Claude Bernard Lyon 1, Université Gustave Eiffel, LBMC UMR_T 9406, Lyon, France
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Lantoine P, Lecocq M, Bougard C, Dousset E, Marqueste T, Bourdin C, Allègre JM, Bauvineau L, Mesure S. Influence of car seat firmness on seat pressure profiles and perceived discomfort during prolonged simulated driving. APPLIED ERGONOMICS 2022; 100:103666. [PMID: 34923297 DOI: 10.1016/j.apergo.2021.103666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
During a driving task, the seat-driver interface is particularly influenced by the external environment and seat features. This study compares the effect of two different seats (S1 - soft & S2 - firm) and the effect of visual simulation of different road types (city, highway, mountain, country), on pressure distribution and perceived discomfort during prolonged driving. Twenty participants drove two 3-h sessions (one per seat) on a static simulator. Contact Pressure (CP), Contact Surface (CS), and Seat Pressure Distribution Percentage (SPD%) were analyzed throughout, using two pressure mats positioned on seat cushion and backrest. Whole-body and local discomfort for each body part were rated every 20 min. The softer seat, S1, induced a greater contact surface on cushion and backrest and a lower SPD%, reflecting better pressure distribution. Pressure profiles were asymmetrical for both S1 and S2, with higher CP under left buttock (LBu) and right lower back (RLb) and greater CS under thighs and RLb. Pressure distribution was less homogeneous on mountain and city roads than on monotonous roads (highway and country). Despite the pressure differences between the seats, however, both led to similar increases in perceived whole-body discomfort throughout the driving session. Moreover, the highest discomfort scores were in the neck and the lower back areas, whatever the seat. These findings on pressure variables may have implications for the design of backrests and cushions to ensure more homogeneous pressure distribution, even though this is not shown to minimize perceived driver discomfort.
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Affiliation(s)
- Pascaline Lantoine
- Stellantis, Centre Technique de Vélizy, Vélizy-Villacoublay, Cedex, France; Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, (UMR 7287), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288, Marseille, Cedex 09, France.
| | - Mathieu Lecocq
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, (UMR 7287), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288, Marseille, Cedex 09, France.
| | - Clément Bougard
- Stellantis, Centre Technique de Vélizy, Vélizy-Villacoublay, Cedex, France.
| | - Erick Dousset
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, (UMR 7287), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288, Marseille, Cedex 09, France.
| | - Tanguy Marqueste
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, (UMR 7287), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288, Marseille, Cedex 09, France.
| | - Christophe Bourdin
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, (UMR 7287), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288, Marseille, Cedex 09, France.
| | - Jean-Marc Allègre
- Stellantis, Centre Technique de Vélizy, Vélizy-Villacoublay, Cedex, France.
| | - Laurent Bauvineau
- Stellantis, Centre Technique de Vélizy, Vélizy-Villacoublay, Cedex, France.
| | - Serge Mesure
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, (UMR 7287), Faculté des Sciences du Sport, CC910, 163, Avenue de Luminy, 13288, Marseille, Cedex 09, France.
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5
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Chen YL. Changes in external ischial tuberosity width at varying trunk-thigh angles between sexes using two measurement methods. Sci Rep 2021; 11:19676. [PMID: 34608250 PMCID: PMC8490358 DOI: 10.1038/s41598-021-99232-w] [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: 06/05/2021] [Accepted: 09/22/2021] [Indexed: 11/12/2022] Open
Abstract
This study examined the influence of two methods and various trunk–thigh (TT) angles on external ischial tuberosity width (EITW) for 45 men and 45 women. In the experiment, the impress and seat pressure methods were applied at TT angles of 60°, 75°, 90°, and 105°. When the impress method was used, EITW remained highly consistent across the four measured TT angles with differences of 2.8 and 2.1 mm for men and women, respectively. Conversely, in the seated pressure method, EITW increased with TT angle such that differences in EITW across a full TT angle range were 11.5 and 11.7 mm for men and women, respectively. Irrespective of method, differences in EITW between genders measured approximately 12.6–13.7 mm across all TT angles. Correlation analyses revealed that hip circumference was positively related to EITW in all cases, whereas the relationship of hip width and depth with EITW varied by method and gender. Because of inherent differences in EITW between genders, these findings suggest that gender variability should be considered in seat cushion design.
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Affiliation(s)
- Yi-Lang Chen
- Department of Industrial Engineering and Management, Ming Chi University of Technology, 84 Gung-Juan Road, Taishan, 24301, New Taipei, Taiwan.
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Gabison S, Mathur S, Nussbaum EL, Popovic MR, Verrier MC. The relationship between pressure offloading and ischial tissue health in individuals with spinal cord injury: An exploratory study. J Spinal Cord Med 2019; 42:186-195. [PMID: 31573438 PMCID: PMC6781203 DOI: 10.1080/10790268.2019.1645404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives: To compare thickness and texture measures of tissue overlying the ischial region in able-bodied (AB) individuals vs. individuals with spinal cord injury (SCI) and to determine if there is a relationship between pressure offloading of the ischial tuberosities (IT) and tissue health in individuals with SCI. Design: Exploratory cross-sectional study. Setting: University setting and rehabilitation hospital. Outcome Measures: Thickness and texture measurements from ultrasound images of tissues overlying the IT were obtained from AB individuals (n = 10) and individuals with complete or incomplete traumatic and non-traumatic SCI American Spinal Injury Association Impairment Scale (AIS) classification A-D (n = 15). Pressure offloading was measured in individuals with SCI and correlated with tissue health measurements. Results: The area overlying the IT occupied by the muscle was significantly greater in the SCI when compared with AB cohort. The area occupied by the muscle in individuals with SCI appeared to lose the striated appearance and was more echogenic than nearby skin and subcutaneous tissue (ST). There was no correlation between offloading times and thickness, echogenicity and contrast measurements of skin, ST and muscle in individuals with SCI. Conclusion: Changes in soft tissues overlying the ischial tuberosity occur following SCI corresponding to the loss of striated appearance of muscle and increased thickness of the area occupied by the muscle. Further studies using a larger sample size are recommended to establish if thickness and tissue texture differ between individuals with SCI who sustain pressure injuries vs. those who do not.
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Affiliation(s)
- Sharon Gabison
- SCI Mobility Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Institute of Medical Science Faculty of Medicine University of Toronto, Toronto, Ontario, Canada,Correspondence to: Sharon Gabison, SCI Mobility Laboratory, Toronto Rehabilitation Institute-University Health Network, 520 Sutherland Drive, Toronto, Ontario M4G 3V9, Canada; Ph: 647-892-4418.
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ethne L. Nussbaum
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,MClSc Program in Field of Wound Healing, Western University, London, Ontario, Canada
| | - Milos R. Popovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Institute of Medical Science Faculty of Medicine University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Mary C. Verrier
- SCI Mobility Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Institute of Medical Science Faculty of Medicine University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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7
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Liu S, Qu Y, Hou S, Li K, Li X, Zhai Y, Ji Y. Comfort evaluation of a subject-specific seating interface formed by vibrating grains. APPLIED ERGONOMICS 2018; 71:65-72. [PMID: 29764615 DOI: 10.1016/j.apergo.2018.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 06/08/2023]
Abstract
Sitting is the most common posture for work in offices, and spinal cord injury (SCI) patients who are wheelchair dependent spend 10.6 h per day seated in wheelchairs. Thus, the comfort of subject-specific interfaces is increasingly important for the well-being of patients and office workers. This paper introduces a new method of forming a subject-specific interface, based on vibrating grains. Twenty subjects (10 females and 10 males) participated in the sitting test. Interface comfort was evaluated using the pressure distribution and subjective rating methods. Five seating interface types were compared. The results showed that compared with a flat interface, the interfaces formed by vibrating grains had a significantly reduced peak contact pressure (PeakCP) (by more than 58.03%), and that PeakCP was highly correlated with the comfort rating (R = -0.533) and discomfort rating(R = -0.603). This new method shows promise for guiding the future development of customized seating interfaces.
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Affiliation(s)
- Shenghui Liu
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu Road No.8, Hongqiao District, Tianjin, 300130, PR China(1)
| | - Yunxia Qu
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu Road No.8, Hongqiao District, Tianjin, 300130, PR China(1)
| | - Shujun Hou
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu Road No.8, Hongqiao District, Tianjin, 300130, PR China(1).
| | - Kai Li
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu Road No.8, Hongqiao District, Tianjin, 300130, PR China(1)
| | - Xinye Li
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu Road No.8, Hongqiao District, Tianjin, 300130, PR China(1)
| | - Yang Zhai
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu Road No.8, Hongqiao District, Tianjin, 300130, PR China(1)
| | - Yunxiao Ji
- School of Mechanical Engineering, Hebei University of Technology, Dingzigu Road No.8, Hongqiao District, Tianjin, 300130, PR China(1)
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8
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Doridam J, Macron A, Vergari C, Verney A, Rohan PY, Pillet H. Feasibility of sub-dermal soft tissue deformation assessment using B-mode ultrasound for pressure ulcer prevention. J Tissue Viability 2018; 27:238-243. [PMID: 30195464 DOI: 10.1016/j.jtv.2018.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/15/2018] [Accepted: 08/10/2018] [Indexed: 10/28/2022]
Abstract
Pressure Ulcer (PU) prevention remains a main public health issue. The physio-pathology of this injury is not fully understood, and a satisfactory therapy is currently not available. Recently, several works suggested that mechanical strains are responsible of deformation-induced damage involved in the initiation of Deep Tissue Injury (DTI). A better assessment of the internal behavior could allow to enhance the modeling of the transmission of loads into the different structures composing the buttock. A few studies focused on the experimental in vivo buttock deformation quantification using Magnetic Resonance Imaging (MRI), but its use has important drawbacks. In clinical practice, ultrasound imaging is an accessible, low cost, and real-time technic to study the soft tissue. The objective of the present work was to show the feasibility of using B-mode ultrasound imaging for the quantification of localised soft-tissue strains of buttock tissues during sitting. An original protocol was designed, and the intra-operator reliability of the method was assessed. Digital Image Correlation was used to compute the displacement field of the soft tissue of the buttock during a full realistic loading while sitting. Reference data of the strains in the frontal and sagittal planes under the ischium were reported for a population of 7 healthy subjects. The average of shear strains over the region of interest in the fat layer reached levels up to 117% higher than the damage thresholds previously quantified for the muscular tissue in rats. In addition, the observation of the muscles displacements seems to confirm previous results which already reported the absence of muscular tissue under the ischium in the seated position, questioning the assumption commonly made in Finite Element modeling that deep tissue injury initiates in the muscle underlying the bone.
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Affiliation(s)
- J Doridam
- Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013, Paris, France; Department of Anatomy, University Paris XIII, UFR Santé Médecine Biologie Humaine, Bobigny, France.
| | - A Macron
- Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013, Paris, France; CEA, LIST, Interactive Robotics Laboratory, F-91191, Gif-sur-Yvette, France
| | - C Vergari
- Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013, Paris, France
| | - A Verney
- CEA, LIST, Interactive Robotics Laboratory, F-91191, Gif-sur-Yvette, France
| | - P-Y Rohan
- Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013, Paris, France
| | - H Pillet
- Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013, Paris, France
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Sonenblum SE, Ma J, Sprigle SH, Hetzel TR, McKay Cathcart J. Measuring the impact of cushion design on buttocks tissue deformation: An MRI approach. J Tissue Viability 2018; 27:162-172. [DOI: 10.1016/j.jtv.2018.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 12/17/2022]
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10
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An MRI investigation of the effects of user anatomy and wheelchair cushion type on tissue deformation. J Tissue Viability 2018; 27:42-53. [DOI: 10.1016/j.jtv.2017.04.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 11/18/2022]
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11
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Al-Dirini RMA, Nisyrios J, Reed MP, Thewlis D. Quantifying the in vivo quasi-static response to loading of sub-dermal tissues in the human buttock using magnetic resonance imaging. Clin Biomech (Bristol, Avon) 2017; 50:70-77. [PMID: 28987874 DOI: 10.1016/j.clinbiomech.2017.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The design of seating systems to improve comfort and reduce injury would benefit from improved understanding of the deformation and strain patterns in soft tissues, particularly in the gluteal region. METHODS Ten healthy men were positioned in a semi-recumbent posture while their pelvic and thigh region was scanned using a wide-bore magnetic resonance imaging (MRI) scanner. Independent measurements of deformation for muscles and fat were taken for the transition from non-weight-bearing to weight-bearing loads in three stages. A weight-bearing load was achieved through having the subject supported by a flat, rigid surface. A non-weight-bearing condition was achieved by removing the support under the left buttock, leaving all soft tissue layers undeformed. An intermediate condition partially relieved the subject's left buttock by lowering the support relative to the pelvis by 20mm, which left the buttock partially deformed. For each of these conditions, the thicknesses of muscle and fat tissues below the ischial tuberosity and the greater trochanter were measured from the MRI data. FINDINGS In this dataset, the greatest soft tissue deformation took place below the ischial tuberosity, with muscles (mean=17.7mm, SD=4.8mm) deforming more than fat tissues (mean=4.3mm, SD=5.6mm). Muscles deformed through both steps of the transition from weight-bearing to non-weight-bearing conditions, while subcutaneous fat deformed little after the first transition from non-weight-bearing to partial-weight-bearing. High inter-subject variability in muscle and fat tissue strains was observed. INTERPRETATION Our findings highlight the importance of considering inter-subject variability when designing seating systems.
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Affiliation(s)
- Rami M A Al-Dirini
- Medical Devices Research Institute, College of Science and Engineering, Flinders University, Adelaide, SA 5001, Australia.
| | - John Nisyrios
- Fowler Simmons Radiology, Adelaide, SA 5000, Australia
| | - Matthew P Reed
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Dominic Thewlis
- Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia
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12
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Al-Dirini RMA, Reed MP, Hu J, Thewlis D. Development and Validation of a High Anatomical Fidelity FE Model for the Buttock and Thigh of a Seated Individual. Ann Biomed Eng 2016; 44:2805-16. [DOI: 10.1007/s10439-016-1560-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 02/01/2016] [Indexed: 11/29/2022]
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13
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Al-Dirini RMA, Reed MP, Thewlis D. Deformation of the gluteal soft tissues during sitting. Clin Biomech (Bristol, Avon) 2015; 30:662-8. [PMID: 26032324 DOI: 10.1016/j.clinbiomech.2015.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/23/2015] [Accepted: 05/14/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Excessive deformation of soft tissues is considered to be one of the major contributing factors to discomfort and injury for individuals who sit for long periods of time. Soft tissue deformation in research has been measured under the assumption that tissues deform uniaxially below the ischium, with very small or negligible deformations taking place in other directions. Therefore, this study describes the deformation of the gluteus maximus muscle and surrounding fat tissues in the buttock region for seated subjects. METHODS In vivo measurements of the deformation for the gluteal soft tissues were obtained from MRI scans of six seated subjects. Each subject was scanned in weight-bearing and non-weight-bearing sitting postures using a Positional MRI scanner (Fonar 0.6 Tesla Indomitable™). Deformations were measured below the ischium and the proximal femur. Deformation of the gluteus maximus was also measured in the distal direction along the thigh for each subject. FINDINGS Our data suggest that soft tissues undergo three-dimensional deformation with considerable components below the ischium (mean of 21.4mm) and in the distal direction along the thigh (mean of 20.3mm). Differences in muscle deformation below the ischium were also observed between obese (mean of 27.4mm) and non-obese subjects (mean of 16.5mm). INTERPRETATION Findings of this study demonstrate that tissue deformations in sitting include complex three-dimensional motions that are not well approximated by two-dimensional models.
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Affiliation(s)
- Rami M A Al-Dirini
- School of Computer Science, Engineering and Mathematics, Flinders University, Adelaide, SA 5001, Australia; School of Engineering, University of South Australia, Adelaide, SA 5001, Australia.
| | - Matthew P Reed
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Dominic Thewlis
- Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
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Kumar N, Sprigle S, Martin JS. Measurement of Load Redistribution Properties of Wheelchair Cushions Using a Compliant Cushion Loading Indenter. Assist Technol 2015; 27:129-35. [DOI: 10.1080/10400435.2014.986772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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15
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3D anatomy and deformation of the seated buttocks. J Tissue Viability 2015; 24:51-61. [DOI: 10.1016/j.jtv.2015.03.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/12/2015] [Accepted: 03/23/2015] [Indexed: 11/23/2022]
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16
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Sonenblum SE, Vonk TE, Janssen TW, Sprigle SH. Effects of wheelchair cushions and pressure relief maneuvers on ischial interface pressure and blood flow in people with spinal cord injury. Arch Phys Med Rehabil 2014; 95:1350-7. [PMID: 24480336 DOI: 10.1016/j.apmr.2014.01.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/10/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To investigate the effectiveness and interactions of 2 methods of pressure ulcer prevention, wheelchair cushions and pressure relief maneuvers, on interface pressure (IP) and blood flow of the buttocks. DESIGN Within-subject repeated measures. SETTING Rehabilitation center. PARTICIPANTS Wheelchair users with a spinal cord injury or disorder (N=17). INTERVENTIONS Participants performed 3 forward leans and 2 sideward leans with different degrees of lean while seated on each of 3 different wheelchair cushions. MAIN OUTCOME MEASURES IP measured with a custom sensor and blood flow measured with laser Doppler flowmetry were collected at the ischial tuberosity. RESULTS Pressure relief maneuvers had a significant main effect on the ischial IP (P<.001); all maneuvers except for the small frontward lean resulted in a significant reduction in IP compared with upright sitting. Blood flow significantly varied across postures (P<.001) with flow during upright sitting and small forward leans being significantly lower than during the full and intermediate leans in both the forward and sideward directions. CONCLUSIONS The results of the study highlight the importance of positioning wheelchair users in a manner that facilitates in-seat movement. Regardless of the cushion being used, the pressure relief maneuvers resulted in very large reductions in IPs and significant increases in buttock blood flow. Only the small frontward lean was shown to be ineffective in reducing pressure or increasing blood flow. Because these pressure relief maneuvers involved postural changes that can occur during functional activities, these pressure relief maneuvers can become a part of volitional pressure relief and functional weight shifts. Therefore, clinical instruction should cover both as a means to impart sitting behaviors that may lead to better tissue health.
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Affiliation(s)
- Sharon E Sonenblum
- Rehabilitation Engineering and Applied Research Laboratory, Georgia Institute of Technology, Atlanta, GA.
| | - Teddie E Vonk
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Thomas W Janssen
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands; Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
| | - Stephen H Sprigle
- Rehabilitation Engineering and Applied Research Laboratory, Georgia Institute of Technology, Atlanta, GA
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17
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Sprigle S, Sonenblum S, Conner-Kerr T. mobilityRERC state of the science conference: individualizing pressure ulcer risk and prevention strategies. Disabil Rehabil Assist Technol 2013; 8:454-61. [DOI: 10.3109/17483107.2013.823574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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