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Fougeron N, Oddes Z, Ashkenazi A, Solav D. Identification of constitutive materials of bi-layer soft tissues from multimodal indentations. J Mech Behav Biomed Mater 2024; 155:106572. [PMID: 38754153 DOI: 10.1016/j.jmbbm.2024.106572] [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: 01/28/2024] [Revised: 04/19/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
The personalisation of finite element models is an important problem in the biomechanical fields where subject-specific analyses are fundamental, particularly in studying soft tissue mechanics. The personalisation includes the choice of the constitutive law of the model's material, as well as the choice of the material parameters. In vivo identification of the material properties of soft tissues is challenging considering the complex behaviour of soft tissues that are, among other things, non-linear hyperelastic and heterogeneous. Hybrid experimental-numerical methods combining in vivo indentations and inverse finite element analyses are common to identify these material parameters. Yet, the uniqueness and the uncertainty of the multi-material hyperelastic model have not been evaluated. This study presents a sensitivity analysis performed on synthetic indentation data to investigate the identification uncertainties of the material parameters in a bi-material thigh phantom. Synthetic numerical data, used to replace experimental measurements, considered several measurement modalities: indenter force and displacement, stereo-camera 3D digital image correlation of the indented surface, and ultrasound B-mode images. A finite element model of the indentation was designed with either Ogden-Moerman or Mooney-Rivlin constitutive laws for both materials. The parameters' identifiability (i.e. the possibility of converging to a unique parameter set within an acceptable margin of error) was assessed with various cost functions formulated using the different synthetic data sets. The results underline the need for multiple experimental modalities to reduce the uncertainty of the identified parameters. Additionally, the experimental error can impede the identification of a unique parameter set, and the cost function depends on the constitutive law. This study highlights the need for sensitivity analyses before the design of the experimental protocol. Such studies can also be used to define the acceptable range of errors in the experimental measurement. Eventually, the impact of the evaluated uncertainty of the identified parameters should be further investigated according to the purpose of the finite element modelling.
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Affiliation(s)
- Nolwenn Fougeron
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel.
| | - Zohar Oddes
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel
| | - Amit Ashkenazi
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel
| | - Dana Solav
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel
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Casarin M, Toniolo I, Todesco M, Carniel EL, Astolfi L, Morlacco A, Moro FD. Mechanical characterization of porcine ureter for the evaluation of tissue-engineering applications. Front Bioeng Biotechnol 2024; 12:1412136. [PMID: 38952671 PMCID: PMC11215493 DOI: 10.3389/fbioe.2024.1412136] [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: 04/04/2024] [Accepted: 05/21/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction: Clinics increasingly require readily deployable tubular substitutes to restore the functionality of structures like ureters and blood vessels. Despite extensive exploration of various materials, both synthetic and biological, the optimal solution remains elusive. Drawing on abundant literature experiences, there is a pressing demand for a substitute that not only emulates native tissue by providing requisite signals and growth factors but also exhibits appropriate mechanical resilience and behaviour. Methods: This study aims to assess the potential of porcine ureters by characterizing their biomechanical properties in their native configuration through ring and membrane flexion tests. In order to assess the tissue morphology before and after mechanical tests and the eventual alteration of tissue microstructure that would be inserted in material constitutive description, histological staining was performed on samples. Corresponding computational analyses were performed to mimic the experimental campaign to identify the constitutive material parameters. Results: The absence of any damages to muscle and collagen fibres, which only compacted after mechanical tests, was demonstrated. The experimental tests (ring and membrane flexion tests) showed non-linearity for material and geometry and the viscoelastic behaviour of the native porcine ureter. Computational models were descriptive of the mechanical behaviour ureteral tissue, and the material model feasible. Discussion: This analysis will be useful for future comparison with decellularized tissue for the evaluation of the aggression of cell removal and its effect on microstructure. The computational model could lay the basis for a reliable tool for the prediction of solicitation in the case of tubular substitutions in subsequent simulations.
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Affiliation(s)
- Martina Casarin
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
| | - Ilaria Toniolo
- Department of Industrial Engineering, University of Padua, Padova, Italy
| | - Martina Todesco
- Department of Civil, Environmental and Architectural Engineering, University of Padua, Padova, Italy
| | | | - Laura Astolfi
- Bioacoustics Research Laboratory, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Alessandro Morlacco
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
| | - Fabrizio Dal Moro
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
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Tan X, Ahmed-Kristensen S, Zhu Q, Han T, Zhu L, Chen W, Cao J, Nanayakkara T. Identification of excessive contact pressures under hand orthosis based on finite element analysis. Prosthet Orthot Int 2024:00006479-990000000-00249. [PMID: 38771762 DOI: 10.1097/pxr.0000000000000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 03/15/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Implicit magnitudes and distribution of excessive contact pressures under hand orthoses hinder clinicians from precisely adjusting them to relieve the pressures. To address this, contact pressure under a hand orthosis were analysed using finite element method. METHODS This paper proposed a method to numerically predict the relatively high magnitudes and critical distribution of contact pressures under hand orthosis through finite element analysis, to identify excessive contact pressure locations. The finite element model was established consisting of the hand, orthosis and bones. The hand and bones were assumed to be homogeneous and elastic bodies, and the orthosis was considered as an isotropic and elastic shell. Two predictions were conducted by assigning either low (fat) or high (skin) material stiffness to the hand model to attain the range of pressure magnitudes. An experiment was conducted to measure contact pressures at the predicted pressure locations. RESULTS Identical pressure distributions were obtained from both predictions with relatively high pressure values disseminated at 12 anatomical locations. The highest magnitude was found at the thumb metacarpophalangeal joint with the maximum pressure range from 13 to 78 KPa. The measured values were within the predicted range of pressure magnitudes. Moreover, 6 excessive contact pressure locations were identified. CONCLUSIONS The proposed method was verified by the measurement results. It renders understanding of interface conditions underneath the orthosis to inform clinicians regarding orthosis design and adjustment. It could also guide the development of 3D printed or sensorised orthosis by indicating optimal locations for perforations or pressure sensors.
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Affiliation(s)
- Xinyang Tan
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | | | - Qian Zhu
- Department of Rehabilitation Medicine, The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, China
| | - Ting Han
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhu
- Dyson School of Design Engineering, Imperial College London, London, UK
| | - Wei Chen
- Department of Rehabilitation Medicine, The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jiangang Cao
- Department of Assistive Technology, International University of Health and Welfare, Otawara, Japan
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Devin KM, Tang J, Hamilton AR, Moser D, Jiang L. Assessment of 3D printed mechanical metamaterials for prosthetic liners. Proc Inst Mech Eng H 2024; 238:348-357. [PMID: 38279687 PMCID: PMC10941651 DOI: 10.1177/09544119231225529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/21/2023] [Indexed: 01/28/2024]
Abstract
This study focuses on novel design and evaluation of Elastic 50A (EL50) mechanical metamaterials with open-cell patterns for its potential application to lower limb residuum/socket interfaces, specifically that of a transtibial (TT) amputee. Mechanical characteristics, that is, effective Young's modulus (E), was tuned by altering metamaterial porosity, which was experimentally verified. Specifically, pore radius of the unit cell was varied to achieve a range of E-values (0.05-1.71 MPa) for these 3D printed metamaterials. Finite Element Analysis (FEA) was conducted to evaluate pressure distribution across key load-bearing anatomical sites of a TT residuum. Using designed metamaterials for homogeneous liners, pressure profiles were studied and compared with a silicone liner case. Additionally, a custom metamaterial liner was designed by assigning appropriate metamaterials to four load-sensitive and tolerant anatomical sites of the TT residuum. The results suggest that lowest pressure variation (PV), as a measure of pressure distribution levels and potential comfort for amputees, was achieved by the custom metamaterial liner compared to any of the homogeneous liners included in this study. It is envisaged that this work may aid future design and development of custom liners using now commonly available 3D printing technologies and available elastomer materials to maximise comfort, tissue safety and overall rehabilitation outcomes for lower limb amputees.
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Affiliation(s)
- Kirstie M Devin
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Jinghua Tang
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Andrew R Hamilton
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - David Moser
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Liudi Jiang
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
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Frossard L, Langton C, Perevoshchikova N, Feih S, Powrie R, Barrett R, Lloyd D. Next-generation devices to diagnose residuum health of individuals suffering from limb loss: A narrative review of trends, opportunities, and challenges. J Sci Med Sport 2023:S1440-2440(23)00032-4. [PMID: 36878761 DOI: 10.1016/j.jsams.2023.02.004] [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: 06/14/2022] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES There is a need for diagnostic devices that can assist prosthetic care providers to better assess and maintain residuum health of individuals suffering from neuromusculoskeletal dysfunctions associated with limb loss. This paper outlines the trends, opportunities, and challenges that will facilitate the development of next-generation diagnostic devices. DESIGN Narrative literature review. METHODS Information about technologies suitable for integration into next-generation diagnostic devices was extracted from 41 references. We considered the invasiveness, comprehensiveness, and practicality of each technology subjectively. RESULTS This review highlighted a trend toward future diagnostic devices of neuromusculoskeletal dysfunctions of the residuum capable to support evidence-based patient-specific prosthetic care, patient empowerment, and the development of bionic solutions. This device should positively disrupt the organization healthcare by enabling cost-utility analyses (e.g., fee-for-device business models) and addressing healthcare gaps due to labor shortages. There are opportunities to develop wireless, wearable and noninvasive diagnostic devices integrating wireless biosensors to measure change in mechanical constraints and topography of residuum tissues during real-life conditions as well as computational modeling using medical imaging and finite element analysis (e.g., digital twin). Developing the next-generation diagnostic devices will require to overcome critical barriers associated with the design (e.g., gaps between technology readiness levels of essential parts), clinical roll-out (e.g., identification of primary users), and commercialization (e.g., limited interest from investors). CONCLUSIONS We anticipate that next-generation diagnostic devices will contribute to prosthetic care innovations that will safely increase mobility, thereby improving the quality of life of the growing global population of individuals suffering from limb loss.
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Affiliation(s)
- Laurent Frossard
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University /Menzies Health Institute Queensland, Australia.
| | - Christian Langton
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University /Menzies Health Institute Queensland, Australia.
| | - Nataliya Perevoshchikova
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University /Menzies Health Institute Queensland, Australia.
| | - Stefanie Feih
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University /Menzies Health Institute Queensland, Australia.
| | | | - Rod Barrett
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University /Menzies Health Institute Queensland, Australia.
| | - David Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University /Menzies Health Institute Queensland, Australia.
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Yang X, Zhao R, Solav D, Yang X, Lee DR, Sparrman B, Fan Y, Herr H. Material, design, and fabrication of custom prosthetic liners for lower-extremity amputees: A review. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Design Evaluation of FFF-Printed Transtibial Prosthetic Sockets Using Follow-Up and Finite Element Analysis. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4040048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Participants in Sierra Leone received a Fused Filament Fabrication (FFF)-printed transtibial prosthetic socket. Follow-up was conducted on this group over a period of 21 months. To investigate the failure of some of the FFF-printed transtibial sockets, further strength investigation is desired. Methods: A finite element (FE) analysis provided an extensive overview of the strength of the socket. Using follow-up data and FE analyses, weak spots were identified, and the required optimization/reinforcement of the socket wall was determined. Results: Five sockets with a 4 mm wall thickness were tested by five participants. The strength of the 4 mm prosthetic socket seemed to be sufficient for people with limited activity. The 4 mm sockets used by active participants failed at the patella tendon or popliteal area. One socket with a wall thickness of 6 mm was used by an active user and remained intact after one year of use. An FE analysis of the socket showed high stresses in the patella tendon area. An increased wall thickness of 7 mm leads to a decrease of 26% in the stress corresponding to the observed failure in the patella tendon area, compared to the 4 mm socket. Conclusions: Follow-up in combination with an FE analysis can provide insight into the strength of the transtibial socket. In future designs, both the patella tendon and popliteal area will be reinforced by a thickened trim line of 7 mm. A design with a thickened trimline of 7 mm is expected to be sufficiently strong for active users. Another follow-up study will be performed to confirm this.
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Frossard L, Conforto S, Aszmann OC. Editorial: Bionics limb prostheses: Advances in clinical and prosthetic care. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:950481. [PMID: 36189016 PMCID: PMC9397676 DOI: 10.3389/fresc.2022.950481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Laurent Frossard
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
- Correspondence: Laurent Frossard
| | | | - Oskar C. Aszmann
- Bionic Laboratory of Extremity Reconstruction and Department of Plastic & Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
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Kelly ES, Worsley PR, Bowen CJ, Cherry LS, Keenan BE, Edwards CJ, O'Brien N, King L, Dickinson AS. Predicting Forefoot-Orthosis Interactions in Rheumatoid Arthritis Using Computational Modelling. Front Bioeng Biotechnol 2022; 9:803725. [PMID: 35004656 PMCID: PMC8733946 DOI: 10.3389/fbioe.2021.803725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
Foot orthoses are prescribed to reduce forefoot plantar pressures and pain in people with rheumatoid arthritis. Computational modelling can assess how the orthoses affect internal tissue stresses, but previous studies have focused on a single healthy individual. This study aimed to ascertain whether simplified forefoot models would produce differing biomechanical predictions at the orthotic interface between people with rheumatoid arthritis of varying severity, and in comparison to a healthy control. The forefoot models were developed from magnetic resonance data of 13 participants with rheumatoid arthritis and one healthy individual. Measurements of bony morphology and soft tissue thickness were taken to assess deformity. These were compared to model predictions (99th% shear strain and plantar pressure, max. pressure gradient, volume of soft tissue over 10% shear strain), alongside clinical data including body mass index and Leeds Foot Impact Scale–Impairment/Footwear score (LFIS-IF). The predicted pressure and shear strain for the healthy participant fell at the lower end of the rheumatoid models’ range. Medial first metatarsal head curvature moderately correlated to all model predicted outcomes (0.529 < r < 0.574, 0.040 < p < 0.063). BMI strongly correlated to all model predictions except pressure gradients (0.600 < r < 0.652, p < 0.05). There were no apparent relationships between model predictions and instances of bursae, erosion and synovial hypertrophy or LFIS-IF score. The forefoot models produced differing biomechanical predictions between a healthy individual and participants with rheumatoid arthritis, and between individuals with rheumatoid arthritis. Models capable of predicting subject specific biomechanical orthotic interactions could be used in the future to inform more personalised devices to protect skin and soft tissue health. While the model results did not clearly correlate with all clinical measures, there was a wide range in model predictions and morphological measures across the participants. Thus, the need for assessment of foot orthoses across a population, rather than for one individual, is clear.
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Affiliation(s)
- Emily S Kelly
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Peter R Worsley
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Catherine J Bowen
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Lindsey S Cherry
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Bethany E Keenan
- Cardiff School of Engineering and Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, United Kingdom
| | | | - Neil O'Brien
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Leonard King
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Alex S Dickinson
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
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Mbithi FM, Chipperfield AJ, Steer JW, Dickinson AS. Developing a control framework for self-adjusting prosthetic sockets incorporating tissue injury risk estimation and generalized predictive control. Biomed Eng Lett 2021; 12:59-73. [DOI: 10.1007/s13534-021-00211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/21/2021] [Accepted: 11/07/2021] [Indexed: 10/19/2022] Open
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