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OBJECTIVE: Alterations to bone-to-cartilage fluid transport may contribute to the development of osteoarthritis (OA). Larger biological molecules in bone may transport from bone-to-cartilage (e.g., insulin, 5 kDa). However, many questions remain about fluid transport between these tissues. The objectives of this study were to (1) test for diffusion of 3 kDa molecular tracers from bone-to-cartilage and (2) assess potential differences in bone-to-cartilage fluid transport between different loading conditions. DESIGN: Osteochondral cores extracted from bovine femurs (N = 10 femurs, 10 cores/femur) were subjected to either no-load (i.e., pure diffusion), pre-load only, or cyclic compression (5 ± 2% or 10 ± 2% strain) in a two-chamber bioreactor. The bone was placed into the bone compartment followed by a 3 kDa dextran tracer, and tracer concentrations in the cartilage compartment were measured every 5 min for 120 min. Tracer concentrations were analyzed for differences in beginning, peak, and equilibrium concentrations, loading effects, and time-to-peak tracer concentration. RESULTS: Peak tracer concentration in the cartilage compartment was significantly higher compared to the beginning and equilibrium tracer concentrations. Cartilage-compartment tracer concentration and maximum fluorescent intensity were influenced by strain magnitude. No time-to-peak relationship was found between strain magnitudes and cartilage-compartment tracer concentration. CONCLUSION: This study shows that bone-to-cartilage fluid transport occurs with 3 kDa dextran molecules. These are larger molecules to move between bone and cartilage than previously reported. Further, these results demonstrate the potential impact of cyclic compression on osteochondral fluid transport. Determining the baseline osteochondral fluid transport in healthy tissues is crucial to elucidating the mechanisms OA pathology.
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Cartilagem Articular , Fêmur , Animais , Bovinos , Cartilagem Articular/metabolismo , Fêmur/metabolismo , Transporte Biológico/fisiologia , Suporte de Carga/fisiologia , Difusão , Dextranos/metabolismo , Reatores Biológicos , Estresse MecânicoRESUMO
OBJECTIVE: To develop and validate a neural network to estimate hip contact forces (HCF), and lower body kinematics and kinetics during walking in individuals with hip osteoarthritis (OA) using synthesised anatomical key points and electromyography. To assess the capability of the neural network to detect directional changes in HCF resulting from prescribed gait modifications. DESIGN: A calibrated electromyography-informed neuromusculoskeletal model was used to compute lower body joint angles, moments, and HCF for 17 participants with mild-to-moderate hip OA. Anatomical key points (e.g., joint centres) were synthesised from marker trajectories and augmented with bias and noise expected from computer vision-based pose estimation systems. Temporal convolutional and long short-term memory neural networks (NN) were trained using leave-one-subject-out validation to predict neuromusculoskeletal modelling outputs from the synthesised key points and measured electromyography data from 5 hip-spanning muscles. RESULTS: HCF was predicted with an average error of 13.4 ± 7.1% of peak force. Joint angles and moments were predicted with an average root-mean-square-error of 5.3 degrees and 0.10 Nm/kg, respectively. The NN could detect changes in peak HCF that occur due to gait modifications with good agreement with neuromusculoskeletal modelling (r2 = 0.72) and a minimum detectable change of 9.5%. CONCLUSION: The developed neural network predicted HCF and lower body joint angles and moments in individuals with hip OA using noisy synthesised key point locations with acceptable errors. Changes in HCF magnitude due to gait modifications were predicted with high accuracy. These findings have important implications for implementation of load-modification based gait retraining interventions for people with hip OA in a natural environment (i.e., home, clinic).
Assuntos
Eletromiografia , Marcha , Articulação do Quadril , Redes Neurais de Computação , Osteoartrite do Quadril , Humanos , Osteoartrite do Quadril/fisiopatologia , Eletromiografia/métodos , Feminino , Masculino , Fenômenos Biomecânicos , Pessoa de Meia-Idade , Articulação do Quadril/fisiopatologia , Idoso , Marcha/fisiologia , Caminhada/fisiologia , Músculo Esquelético/fisiopatologia , Suporte de Carga/fisiologiaRESUMO
OBJECTIVE: Understanding gender-specific differences in patterns of cartilage loss can improve our knowledge of the pathogenesis of knee osteoarthritis (KOA) development and progression and may inform clinical trials of treatments for KOA. The goal of our observational study was to examine gender differences in patterns of cartilage loss in the central weight-bearing regions of the femur. METHODS: We measured cartilage volume change in the indexed knee of 700 subjects with Kellgren-Lawrence 1, 2, or 3 from the Osteoarthritis Initiative for four follow-up periods (baseline [BL] to 24 mo, BL to 48 mo, BL to 72 mo, and BL to 96 mo) using the local area cartilage segmentation (LACS) method. Briefly, the LACS method uses robust coordinate systems fixed to anatomical landmarks to measure patterns of change in cartilage volume in sub-regions using responsiveness heat maps. RESULTS: We observed a statistically significant gender difference in cartilage change in the medial femur (MF), lateral femur (LF), and medial tibia. The heat maps showed loss was primarily in the posterior central weight-bearing portion of the LF and more general in the LT and MF. Similar patterns were observed for each of the four follow-up periods. CONCLUSIONS: The LACS method was capable of illustrating gender-specific differences in patterns of cartilage loss that may offer insight into the variation of gender differences in the natural history of KOA and may be useful in evaluating the benefit of interventions for KOA.
Assuntos
Cartilagem Articular , Fêmur , Osteoartrite do Joelho , Humanos , Feminino , Masculino , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/fisiopatologia , Cartilagem Articular/patologia , Cartilagem Articular/diagnóstico por imagem , Pessoa de Meia-Idade , Idoso , Fêmur/patologia , Fêmur/diagnóstico por imagem , Fatores Sexuais , Imageamento por Ressonância Magnética , Suporte de Carga/fisiologia , Articulação do Joelho/patologia , Progressão da Doença , Tíbia/patologia , Caracteres SexuaisRESUMO
OBJECTIVE: Transient receptor potential vanilloid 4 (TRPV4) is a multi-modally activated cation channel that mediates mechanotransduction pathways by which musculoskeletal tissues respond to mechanical load and regulate tissue health. Using conditional Trpv4 knockout mice, we investigated the role of Trpv4 in regulating intervertebral disc (IVD) health and injury-induced IVD degeneration. METHODS: Col2-Cre;Trpv4fl/f (Trpv4 KO) mice were used to knockout Trpv4 in all type 2 collagen-expressing cells. Effects of gene targeting alone was assessed in lumbar spines, using vertebral bone length measurement, histological, immunohistochemistry and gene expression analyses, and mechanical testing. Disc puncture was performed on caudal IVDs of wild-type (WT) and Trpv4 KO mice at 2.5- and 6.5-months-of-age. Six weeks after puncture (4- and 8-months-of-age at sacrifice), caudal spines were assessed using histological analyses. RESULTS: While loss of Trpv4 did not significantly alter vertebral bone length and tissue histomorphology compared to age-matched WT mice, Trpv4 KO mice showed decreased proteoglycan and PRG4 staining in the annulus fibrosus compared to WT. At the gene level, Trpv4 KO mice showed significantly increased expression of Acan, Bgn, and Prg4 compared to WT. Functionally, loss of Trpv4 was associated with significantly increased neutral zone length in lumbar IVDs. Following puncture, both Trpv4 KO and WT mice showed similar signs of degeneration at the site of injury. Interestingly, loss of Trpv4 prevented mechanically-induced degeneration in IVDs adjacent to sites of injury. CONCLUSION: These studies suggest a role for Trpv4 in regulating extracellular matrix synthesis and mediating the response of IVD tissues to mechanical stress.
Assuntos
Modelos Animais de Doenças , Matriz Extracelular , Degeneração do Disco Intervertebral , Camundongos Knockout , Canais de Cátion TRPV , Animais , Canais de Cátion TRPV/metabolismo , Canais de Cátion TRPV/genética , Degeneração do Disco Intervertebral/metabolismo , Degeneração do Disco Intervertebral/patologia , Camundongos , Matriz Extracelular/metabolismo , Disco Intervertebral/metabolismo , Disco Intervertebral/patologia , Vértebras Lombares , Suporte de Carga/fisiologia , Colágeno Tipo II/metabolismo , Mecanotransdução Celular/fisiologia , Agrecanas/metabolismo , Estresse Mecânico , Proteoglicanas/metabolismo , Proteoglicanas/genéticaRESUMO
The aim of this study was to determine whether the Bone Strain Index (BSI), a recent DXA-based bone index, is related to bone mechanical behavior, microarchitecture and finally, to determine whether BSI improves the prediction of bone strength and the predictive role of BMD in clinical practice. PURPOSE: Bone Strain Index (BSI) is a new DXA-based bone index that represents the finite element analysis of the bone deformation under load. The current study aimed to assess whether the BSI is associated with 3D microarchitecture and the mechanical behavior of human lumbar vertebrae. METHODS: Lumbar vertebrae (L3) were harvested fresh from 31 human donors. The anteroposterior BMC (g) and aBMD (g/cm2) of the vertebral body were measured using DXA, and then the BSI was automatically derived. The trabecular bone volume (Tb.BV/TV), trabecular thickness (Tb.Th), degree of anisotropy (DA), and structure model index (SMI) were measured using µCT with a 35-µm isotropic voxel size. Quasi-static uniaxial compressive testing was performed on L3 vertebral bodies under displacement control to assess failure load and stiffness. RESULTS: The BSI was significantly correlated with failure load and stiffness (r = -0.60 and -0.59; p < 0.0001), aBMD and BMC (r = -0.93 and -0.86; p < 0.0001); Tb.BV/TV and SMI (r = -0.58 and 0.51; p = 0.001 and 0.004 respectively). After adjustment for aBMD, the association between BSI and stiffness, BSI and SMI remained significant (r = -0.51; p = 0.004 and r = -0.39; p = 0.03 respectively, partial correlations) and the relation between BSI and failure load was close to significance (r = -0.35; p = 0.06). CONCLUSION: The BSI was significantly correlated with the microarchitecture and mechanical behavior of L3 vertebrae, and these associations remained statistically significant regardless of aBMD.
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Absorciometria de Fóton , Densidade Óssea , Análise de Elementos Finitos , Vértebras Lombares , Estresse Mecânico , Microtomografia por Raio-X , Humanos , Vértebras Lombares/fisiologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Feminino , Densidade Óssea/fisiologia , Idoso , Masculino , Pessoa de Meia-Idade , Absorciometria de Fóton/métodos , Fenômenos Biomecânicos/fisiologia , Microtomografia por Raio-X/métodos , Osso Esponjoso/diagnóstico por imagem , Osso Esponjoso/fisiologia , Suporte de Carga/fisiologia , Idoso de 80 Anos ou mais , Força Compressiva/fisiologia , Adulto , AnisotropiaRESUMO
This study investigates the effects of varying loading conditions on excitability in neural pathways and gait dynamics. We focussed on evaluating the magnitude of the Hoffman reflex (H-reflex), a neurophysiological measure representing the capability to activate motor neurons and the timing and placement of the foot during walking. We hypothesized that weight manipulation would alter H-reflex magnitude, footfall and lower body kinematics. Twenty healthy participants were recruited and subjected to various weight-loading conditions. The H-reflex, evoked by stimulating the tibial nerve, was assessed from the dominant leg during walking. Gait was evaluated under five conditions: body weight, 20% and 40% additional body weight, and 20% and 40% reduced body weight (via a harness). Participants walked barefoot on a treadmill under each condition, and the timing of electrical stimulation was set during the stance phase shortly after the heel strike. Results show that different weight-loading conditions significantly impact the timing and placement of the foot and gait stability. Weight reduction led to a 25% decrease in double limb support time and an 11% narrowing of step width, while weight addition resulted in an increase of 9% in step width compared to body weight condition. Furthermore, swing time variability was higher for both the extreme weight conditions, while the H-reflex reduced to about 45% between the extreme conditions. Finally, the H-reflex showed significant main effects on variability of both stance and swing phases, indicating that muscle-motor excitability might serve as feedback for enhanced regulation of gait dynamics under challenging conditions.
Assuntos
Marcha , Reflexo H , Caminhada , Suporte de Carga , Humanos , Marcha/fisiologia , Reflexo H/fisiologia , Masculino , Adulto , Feminino , Suporte de Carga/fisiologia , Fenômenos Biomecânicos/fisiologia , Adulto Jovem , Caminhada/fisiologia , Estimulação Elétrica/métodos , Músculo Esquelético/fisiologia , Nervo Tibial/fisiologia , Eletromiografia , Pé/fisiologia , Adaptação Fisiológica/fisiologia , Neurônios Motores/fisiologia , Peso Corporal/fisiologiaRESUMO
BACKGROUND: Understanding how healthy articular cartilage responds to mechanical loading is critical. Moderate mechanical loading has positive effects on the cartilage, such as maintaining cartilage homeostasis. The degree of mechanical loading is determined by a combination of intensity, frequency, and duration; however, the best combination of these parameters for knee cartilage remains unclear. This study aimed to determine which combination of intensity, frequency, and duration provides the best mechanical loading on healthy knee articular cartilage in vitro and in vivo. METHODS AND RESULTS: In this study, 33 male mice were used. Chondrocytes isolated from mouse knee joints were subjected to different cyclic tensile strains (CTSs) and assessed by measuring the expression of cartilage matrix-related genes. Furthermore, the histological characteristics of mouse tibial cartilages were quantified using different treadmill exercises. Chondrocytes and mice were divided into the control group and eight intervention groups: high-intensity, high-frequency, and long-duration; high-intensity, high-frequency, and short-duration; high-intensity, low-frequency, and long-duration; high-intensity, low-frequency, and short-duration; low-intensity, high-frequency, and long-duration; low-intensity, high-frequency, and short-duration; low-intensity, low-frequency, and long-duration; low-intensity, low-frequency, and short-duration. In low-intensity CTSs, chondrocytes showed anabolic responses by altering the mRNA expression of COL2A1 in short durations and SOX9 in long durations. Furthermore, low-intensity, low-frequency, and long-duration treadmill exercises minimized chondrocyte hypertrophy and enhanced aggrecan synthesis in tibial cartilages. CONCLUSION: Low-intensity, low-frequency, and long-duration mechanical loading is the best combination for healthy knee cartilage to maintain homeostasis and activate anabolic responses. Our findings provide a significant scientific basis for exercise and lifestyle instructions.
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Cartilagem Articular , Condrócitos , Estresse Mecânico , Suporte de Carga , Animais , Cartilagem Articular/metabolismo , Cartilagem Articular/fisiologia , Camundongos , Condrócitos/metabolismo , Masculino , Suporte de Carga/fisiologia , Condicionamento Físico Animal/fisiologia , Fatores de Transcrição SOX9/metabolismo , Fatores de Transcrição SOX9/genética , Colágeno Tipo II/metabolismo , Colágeno Tipo II/genética , Articulação do Joelho/metabolismo , Articulação do Joelho/fisiologia , Camundongos Endogâmicos C57BLRESUMO
PURPOSE: A broad functional movement repertoire is crucial for engaging in physical activity and reducing the risk of injury, both of which are central aspects of lifelong health. As a fundamental exercise in both recreational and rehabilitative training regimes, the bipedal squat (SQBp) incorporates many everyday movement patterns. Crucially, SQBp can only be considered functional if the practitioner can meet the coordinative demands. Many factors affect coordinative aspects of an exercise, most notably external load. Since compound movements are assumed to be organized in a synergistic manner, we employed muscle synergy analysis to examine differences in muscle synergy properties between various external load levels during SQBp. METHODS: Ten healthy male recreational athletes were enrolled in the present study. Each participant performed three sets of ten SQBp on a smith machine at three submaximal load levels (50%, 62.5%, and 75% of 3 repetition maximum) across three non-consecutive days. Muscle activity was recorded from 12 prime movers of SQBp by way of electromyography (EMG). Muscle synergies were analyzed in terms of temporal activation patterns, i.e., waveform, as well as the relative input of each muscle into individual synergies, i.e., weight contribution. RESULTS: Waveforms of muscle synergies did not differ between loads. Weight contributions showed significant differences between load levels, albeit only for the gastrocnemius muscle in a single synergy. CONCLUSION: Taken together, our results imply mostly stable spatiotemporal composition of muscle activity during SQBp, underlining the importance of technical competence during compound movement performance in athletic and rehabilitative settings.
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Músculo Esquelético , Humanos , Masculino , Músculo Esquelético/fisiologia , Adulto , Movimento/fisiologia , Contração Muscular/fisiologia , Adulto Jovem , Suporte de Carga/fisiologia , Eletromiografia , Exercício Físico/fisiologiaRESUMO
PURPOSE: Understanding the test-retest reliability of physiological responses to load carriage influences the interpretation of those results. The aim of this study was to determine the test-retest reliability of physiological measures during loaded treadmill walking at 5.5 km h-1 using the MetaMax 3B. METHODS: Fifteen Australian Army soldiers (9 male, 6 female) repeated two 12-min bouts of treadmill walking at 5.5 km h-1 in both a 7.2 kg Control condition (MetaMax 3B, replica rifle) and a 23.2 kg Patrol condition (Control condition plus vest) across three sessions, separated by one week. Expired respiratory gases and heart rate were continuously collected, with the final 3 min of data analysed. Ratings of Perceived Exertion and Omnibus-Resistance Exercise Scale were taken following each trial. Reliability was quantified by coefficient of variation (CV), intra-class correlation coefficients (ICC), smallest worthwhile change (SWC), and standard error of the measurement. RESULTS: Metabolic and cardiovascular variables were highly reliable (≤ 5% CV; excellent-moderate ICC), while the respiratory variables demonstrated moderate reliability (< 8% CV; good-moderate ICC) across both conditions. Perceptual ratings had poorer reliability during the Control condition (12-45% CV; poor ICC) than the Patrol condition (7-16% CV; good ICC). CONCLUSIONS: The test-retest reliability of metabolic and cardiovascular variables was high and relatively consistent during load carriage. Respiratory responses demonstrated moderate test-retest reliability; however, as the SWC differed with load carriage tasks, such data should be interpreted independently across loads. Perceptual measures demonstrated poor to moderate reliability during load carriage, and it is recommended that they only be employed as secondary measures.
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Teste de Esforço , Frequência Cardíaca , Suporte de Carga , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Teste de Esforço/métodos , Teste de Esforço/normas , Suporte de Carga/fisiologia , Adulto , Frequência Cardíaca/fisiologia , Caminhada/fisiologia , Esforço Físico/fisiologia , Adulto Jovem , Percepção/fisiologia , Militares , Consumo de Oxigênio/fisiologiaRESUMO
Unstable trauma lesion of the spinopelvic junction, including U-shaped sacral fractures and Tile C pelvic ring disruptions, require surgical stabilization in order to realign the bone arches of the pelvis thus reducing the upcoming orthopaedic impairment during sitting, standing, and walking positions, decompress the nerves roots of the cauda equina in a view of reducing neurological impairment, and allow early weight bearing. Even though posterior open modified triangular spinopelvic fixation is particularly efficient for treating unstable trauma lesions of the spinopelvic junction, it may not be sufficient alone in order to prevent long-term counter-nutation, i.e. rotation and anteflexion deformity of the anterior pelvis under load bearing conditions. Such progressive deformation is caused by either the slight rotation of the iliac connectors within the head of iliac screws for spinopelvic constructs, or the slight rotation of sacral cancellous bone around transsacral screws in case of percutaneous procedure. Regardless of the posterior surgical technique that is used, complementary anterior pelvic fixation appears mandatory in order to prevent such deformation over time, which can lead to pelvic asymmetry and then gait imbalance.
Assuntos
Fixação Interna de Fraturas , Ossos Pélvicos , Sacro , Fraturas da Coluna Vertebral , Humanos , Sacro/cirurgia , Ossos Pélvicos/cirurgia , Ossos Pélvicos/lesões , Fixação Interna de Fraturas/métodos , Fraturas da Coluna Vertebral/cirurgia , Suporte de Carga/fisiologia , Parafusos Ósseos , Pelve/cirurgiaRESUMO
PURPOSE: To analyze the effect of endplate weakness prior to PLIF or TLIF cage implantation and compare it to the opposite intact endplate of the same vertebral body. In addition, the influence of bone quality on endplate resistance was investigated. METHODS: Twenty-two human lumbar vertebrae were tested in a ramp-to-failure test. One endplate of each vertebral body was tested intact and the other after weakening with a rasp (over an area of 200 mm2). Either a TLIF or PLIF cage was then placed and the compression load was applied across the cage until failure of the endplate. Failure was defined as the first local maximum of the force measurement. Bone quality was assessed by determining the Hounsfield units (HU) on CT images. RESULTS: With an intact endplate and a TLIF cage, the median force to failure was 1276.3N (693.1-1980.6N). Endplate weakening reduced axial endplate resistance to failure by 15% (0-23%). With an intact endplate and a PLIF cage, the median force to failure was 1057.2N (701.2-1735.5N). Endplate weakening reduced axial endplate resistance to failure by 36.6% (7-47.9%). Bone quality correlated linearly with the force at which endplate failure occurred. Intact and weakened endplates showed a strong positive correlation: intact-TLIF: r = 0.964, slope of the regression line (slope) = 11.8, p < 0.001; intact-PLIF: r = 0.909, slope = 11.2, p = 5.5E-05; weakened-TLIF: r = 0.973, slope = 12.5, p < 0.001; weakened-PLIF: r = 0.836, slope = 6, p = 0.003. CONCLUSION: Weakening of the endplate during cage bed preparation significantly reduces the resistance of the endplate to subsidence to failure: endplate load capacity is reduced by 15% with TLIF and 37% with PLIF. Bone quality correlates with the force at which endplate failure occurs.
Assuntos
Vértebras Lombares , Fusão Vertebral , Suporte de Carga , Humanos , Fusão Vertebral/métodos , Vértebras Lombares/cirurgia , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Masculino , Idoso , Feminino , Suporte de Carga/fisiologia , Fenômenos Biomecânicos/fisiologia , Adulto , Idoso de 80 Anos ou maisRESUMO
BACKGROUND: This study investigated the effects of changes in motor skills from an educational video program on the kinematic and kinetic variables of the lower extremity joints and knee ligament load. METHODS: Twenty male participants (age: 22.2 ± 2.60 y; height: 1.70 ± 6.2 m; weight: 65.4 ± 7.01 kg; BMI: 23.32 ± 2.49 [Formula: see text]) were instructed to run at 4.5 ± 0.2 m/s from a 5 m distance posterior to the force plate, land their foot on the force plate, and perform the cutting maneuver on the left. The educational video program for cutting maneuvers consisted of preparatory posture, foot landing orientation, gaze and trunk directions, soft landing, and eversion angle. The measured variables were the angle, angular velocity of lower extremity joints, ground reaction force (GRF), moment, and anterior cruciate ligament (ACL) and medial collateral ligament (MCL) forces through musculoskeletal modeling. RESULTS: After the video feedback, the hip joint angles increased in flexion, abduction, and external rotation (p < 0.05), and the angular velocity increased in extension (p < 0.05). The ankle joint angles increased in dorsiflexion (p < 0.05), and the angular velocity decreased in dorsiflexion (p < 0.05) but increased in abduction (p < 0.05). The GRF increased in the anterior-posterior and medial-lateral directions and decreased vertically (p < 0.05). The hip joint moments decreased in extension and external rotation (p < 0.05) but increased in adduction (p < 0.05). The knee joint moments were decreased in extension, adduction, and external rotation (p < 0.05). The abduction moment of the ankle joint decreased (p < 0.001). There were differences in the support zone corresponding to 64â87% of the hip frontal moment (p < 0.001) and 32â100% of the hip horizontal moment (p < 0.001) and differences corresponding to 32â100% of the knee frontal moment and 21â100% of the knee horizontal moment (p < 0.001). The GRF varied in the support zone at 44â95% in the medial-lateral direction and at 17â43% and 73â100% in the vertical direction (p < 0.001). CONCLUSIONS: Injury prevention feedback reduced the load on the lower extremity joints during cutting maneuvers, which reduced the knee ligament load, mainly on the MCL.
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Articulação do Joelho , Destreza Motora , Suporte de Carga , Humanos , Masculino , Adulto Jovem , Suporte de Carga/fisiologia , Articulação do Joelho/fisiologia , Fenômenos Biomecânicos/fisiologia , Destreza Motora/fisiologia , Gravação em Vídeo , Articulação do Quadril/fisiologia , Articulação do Tornozelo/fisiologia , Adulto , Corrida/fisiologia , Extremidade Inferior/fisiologiaRESUMO
BACKGROUND: Developmental dysplasia of the hip causes secondary osteoarthritis. Finite element analysis suggests high hip joint contact pressure in patients with hip dysplasia and a reduction in contact pressure after periacetabular osteotomy. However, few biomechanical studies have examined the load distribution in the hip joint. This study aimed to investigate the biomechanical properties of load distribution in porcine hip joints at different acetabular coverages. METHODS: Six porcine hip joints were analyzed using three models: 1) neutral coverage, 2) 15° under-coverage (defined as dysplasia model), and 3) 15° over-coverage created by varying the acetabular coverage. The load distribution was assessed using a pressure-mapping sensor system after applying a loading force of 100 N to the hip joint. RESULTS: In the dysplasia model, the load was concentrated at the acetabular rim; in the neutral and over-coverage models, it was dispersed. The average contact pressure was significantly higher in the dysplasia model than in the neutral coverage model ([0.42 vs. 0.3 MPa]; p = 0.004). The contact area was significantly smaller in the dysplasia model than in the neutral coverage model ([250.7 vs. 345.0 mm2]; p = 0.004). No significant differences were observed in contact pressure or area between the neutral and over-coverage models. CONCLUSIONS: Insufficient acetabular coverage in the dysplasia model demonstrated higher contact pressure and smaller contact area than the neutral model. Conversely, the contact pressure and area in the over-coverage model did not differ significantly from those in the normal model. Therefore, surgeons should note that acetabular coverage overcorrection has limited effect; normalization is crucial during periacetabular osteotomy.
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Acetábulo , Articulação do Quadril , Suporte de Carga , Animais , Acetábulo/cirurgia , Acetábulo/fisiopatologia , Fenômenos Biomecânicos/fisiologia , Suporte de Carga/fisiologia , Suínos , Articulação do Quadril/cirurgia , Articulação do Quadril/fisiopatologia , Análise de Elementos Finitos , Displasia do Desenvolvimento do Quadril/cirurgia , Displasia do Desenvolvimento do Quadril/fisiopatologia , PressãoRESUMO
INTRODUCTION: Anterior cruciate ligament (ACL) ruptures are common injuries that typically affect young, physically active individuals and may require surgical reconstruction. Studies have shown that the long time success of ACL reconstruction depends on the surgical technique and the postoperative rehabilitation strategy. However, there is still no consensus on the content of rehabilitation programs. Hence, additional research is required to elucidate the significance of early weight-bearing in the rehabilitation process following ACL reconstruction. The aim of this article is to examine the impact of weight-bearing on the clinical results of ACL reconstruction. MATERIALS AND METHODS: We retrospectively reviewed patient records who had undergone arthroscopic reconstruction using a semitendinosus-gracilis tendon graft for anterior cruciate ligament rupture between January 2018 and December 2020. The study included the data of 110 patients. The patients were split into two groups: Group 1 underwent early weight-bearing, while Group 2 followed a non-weight-bearing regimen for three weeks. We assessed the patients using the anterior drawer test, Lachman test, range of motion, Lysholm knee scale, Cincinnati scale, Tegner scale, International Knee Documentation Committee (IKDC) form and clinical records. Analytical tests were conducted to compare the results. RESULTS: The complication rates did not show a significant difference between the groups. Group 1 had higher frequencies of positive anterior drawer and Lachman tests. The Lysholm and Cincinnati knee scores of patients in Group 1 were notably lower than those of patients in Group 2. Additionally, the Tegner activity scores and IKDC scores of patients in Group 1 were also meaningfully lower than those of patients in Group 2. In Group 1 patients, there was no notable relationship observed between body mass index (BMI) and the results of the anterior drawer test (ADT) or Lachman test. However, patients with a BMI of 25 or higher in Group 1 showed a decrease in postoperative IKDC scores. In Group 2 patients, no significant relationship was identified between BMI and either the ADT or the Lachman test outcome. CONCLUSION: Based on current literature and current rehabilitation guidelines following ACL reconstruction, the decision to initiate early weight-bearing is based on a limited number of studies with low levels of evidence. In our study, we found that patients who followed a non-weight-bearing regimen for 3 weeks after surgery had better mid-term results than those who were allowed to bear weight early. It appears that further prospective studies on this topic are needed to update rehabilitation guidelines in the next.
Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Suporte de Carga , Humanos , Reconstrução do Ligamento Cruzado Anterior/reabilitação , Reconstrução do Ligamento Cruzado Anterior/métodos , Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Estudos Retrospectivos , Feminino , Suporte de Carga/fisiologia , Masculino , Adulto , Lesões do Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/reabilitação , Adulto Jovem , Resultado do Tratamento , Amplitude de Movimento Articular , Artroscopia/efeitos adversos , Artroscopia/métodos , Recuperação de Função Fisiológica , Ligamento Cruzado Anterior/cirurgia , Articulação do Joelho/cirurgia , Articulação do Joelho/fisiopatologia , AdolescenteRESUMO
BACKGROUND: Ulnar impingement syndrome is a prevalent source of ulnar carpal pain; however, there is ongoing debate regarding the specific location of shortening, the method of osteotomy, the extent of shortening, and the resulting biomechanical alterations. METHOD: To investigate the biomechanical changes in the distal radioulnar joint (DRUJ) resulting from different osteotomy methods, a cadaveric specimen was dissected, and the presence of a stable DRUJ structure was confirmed. Subsequently, three-dimensional data of the specimen were obtained using a CT scan, and finite element analysis was conducted after additional processing. RESULTS: The DRUJ stress did not change significantly at the metaphyseal osteotomy of 2-3 mm but increased significantly when the osteotomy length reached 5 mm. When the osteotomy was performed at the diaphysis, the DRUJ stress increased with the osteotomy length, and the increase was greater than that of metaphyseal osteotomy. Stress on the DRUJ significantly increases when the position is changed to pronation dorsi-extension. Similarly, the increase in stress in diaphyseal osteotomy was greater than that in metaphyseal osteotomy. When the model was subjected to a longitudinal load of 100 N, neither osteotomy showed a significant change in DRUJ stress at the neutral position. However, the 100 N load significantly increased stress on the DRUJ when the position was changed to pronation dorsi-extension, and the diaphyseal osteotomy significantly increased stress on the DRUJ. CONCLUSIONS: For patients with distal oblique bundle, metaphyseal osteotomy result in a lower increase in intra-articular pressure in the DRUJ compared to diaphyseal osteotomy. However, it is crucial to note that regardless of the specific type of osteotomy employed, it is advisable to avoid a shortening length exceeding 5 mm.
Assuntos
Cadáver , Análise de Elementos Finitos , Osteotomia , Ulna , Articulação do Punho , Humanos , Osteotomia/métodos , Osteotomia/efeitos adversos , Articulação do Punho/cirurgia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/fisiopatologia , Ulna/cirurgia , Ulna/diagnóstico por imagem , Fenômenos Biomecânicos/fisiologia , Estresse Mecânico , Suporte de Carga/fisiologia , MasculinoRESUMO
Accurate assessment of rolling resistance is important for wheelchair propulsion analyses. However, the commonly used drag and deceleration tests are reported to underestimate rolling resistance up to 6% due to the (neglected) influence of trunk motion. The first aim of this study was to investigate the accuracy of using trunk and wheelchair kinematics to predict the intra-cyclical load distribution, more particularly front wheel loading, during hand-rim wheelchair propulsion. Secondly, the study compared the accuracy of rolling resistance determined from the predicted load distribution with the accuracy of drag test-based rolling resistance. Twenty-five able-bodied participants performed hand-rim wheelchair propulsion on a large motor-driven treadmill. During the treadmill sessions, front wheel load was assessed with load pins to determine the load distribution between the front and rear wheels. Accordingly, a machine learning model was trained to predict front wheel load from kinematic data. Based on two inertial sensors (attached to the trunk and wheelchair) and the machine learning model, front wheel load was predicted with a mean absolute error (MAE) of 3.8% (or 1.8 kg). Rolling resistance determined from the predicted load distribution (MAE: 0.9%, mean error (ME): 0.1%) was more accurate than drag test-based rolling resistance (MAE: 2.5%, ME: -1.3%).
Assuntos
Tronco , Cadeiras de Rodas , Humanos , Fenômenos Biomecânicos , Masculino , Adulto , Feminino , Adulto Jovem , Tronco/fisiologia , Aprendizado de Máquina , Desenho de Equipamento , Suporte de Carga/fisiologia , Teste de Esforço/métodosRESUMO
The introduction of resistant and lightweight materials in the construction industry has led to civil structures being vulnerable to excessive vibrations, particularly in footbridges exposed to human-induced gait loads. This interaction, known as Human-Structure Interaction (HSI), involves a complex interplay between structural vibrations and gait loads. Despite extensive research on HSI, the simultaneous effects of lateral structural vibrations with fundamental frequencies close to human gait frequency (around 1.0 Hz) and wide amplitudes (over 30.0 mm) remain inadequately understood, posing a contemporary structural challenge highlighted by incidents in iconic bridges like the Millennium Bridge in London, Solferino Bridge in Paris, and Premier Bridge in Cali, Colombia. This paper focuses on the experimental exploration of Structure-to-Human Interaction (S2HI) effects using the Human-Structure Interaction Multi-Axial Test Framework (HSI-MTF). The framework enables the simultaneous measurement of vertical and lateral loads induced by human gait on surfaces with diverse frequency ranges and wide-amplitude lateral harmonic motions. The study involved seven test subjects, evaluating gait loads on rigid and harmonic lateral surfaces with displacements ranging from 5.0 to 50.0 mm and frequency content from 0.70 to 1.30 Hz. A low-cost vision-based motion capture system with smartphones analyzed the support (Tsu) and swing (Tsw) periods of human gait. Results indicated substantial differences in Tsu and Tsw on lateral harmonic protocols, reaching up to 96.53% and 58.15%, respectively, compared to rigid surfaces. Normalized lateral loads (LL) relative to the subject's weight (W0) exhibited a linear growth proportional to lateral excitation frequency, with increased proportionality constants linked to higher vibration amplitudes. Linear regressions yielded an average R2 of 0.815. Regarding normalized vertical load (LV) with respect to W0, a consistent behavior was observed for amplitudes up to 30.0 mm, beyond which a linear increase, directly proportional to frequency, resulted in a 28.3% increment compared to rigid surfaces. Correlation analyses using Pearson linear coefficients determined relationships between structural surface vibration and pedestrian lateral motion, providing valuable insights into Structure-to-Human Interaction dynamics.
Assuntos
Marcha , Pedestres , Vibração , Humanos , Marcha/fisiologia , Masculino , Adulto , Smartphone , Suporte de Carga/fisiologia , Caminhada/fisiologia , Fenômenos BiomecânicosRESUMO
Hoof care providers are pivotal for implementing biomechanical optimizations of the musculoskeletal system in the horse. Regular visits allow for the collection of longitudinal, quantitative information ("normal ranges"). Changes in movement symmetry, e.g., after shoeing, are indicative of alterations in weight-bearing and push-off force production. Ten Warmblood show jumping horses (7-13 years; 7 geldings, 3 mares) underwent forelimb re-shoeing with rolled rocker shoes, one limb at a time ("limb-by-limb"). Movement symmetry was measured with inertial sensors attached to the head, withers, and pelvis during straight-line trot and lunging. Normalized differences pre/post re-shoeing were compared to published test-retest repeatability values. Mixed-model analysis with random factors horse and limb within horse and fixed factors surface and exercise direction evaluated movement symmetry changes (p < 0.05, Bonferroni correction). Withers movement indicated increased forelimb push-off with the re-shod limb on the inside of the circle and reduced weight-bearing with the re-shod limb and the ipsilateral hind limb on hard ground compared to soft ground. Movement symmetry measurements indicate that a rolled rocker shoe allows for increased push-off on soft ground in trot in a circle. Similar studies should study different types of shoes for improved practically relevant knowledge about shoeing mechanics, working towards evidence-based preventative shoeing.
Assuntos
Membro Anterior , Sapatos , Animais , Cavalos/fisiologia , Membro Anterior/fisiologia , Fenômenos Biomecânicos/fisiologia , Movimento/fisiologia , Suporte de Carga/fisiologia , Marcha/fisiologia , Feminino , Masculino , Membro Posterior/fisiologiaRESUMO
Laboratory studies have limitations in screening for anterior cruciate ligament (ACL) injury risk due to their lack of ecological validity. Machine learning (ML) methods coupled with wearable sensors are state-of-art approaches for joint load estimation outside the laboratory in athletic tasks. The aim of this study was to investigate ML approaches in predicting knee joint loading during sport-specific agility tasks. We explored the possibility of predicting high and low knee abduction moments (KAMs) from kinematic data collected in a laboratory setting through wearable sensors and of predicting the actual KAM from kinematics. Xsens MVN Analyze and Vicon motion analysis, together with Bertec force plates, were used. Talented female football (soccer) players (n = 32, age 14.8 ± 1.0 y, height 167.9 ± 5.1 cm, mass 57.5 ± 8.0 kg) performed unanticipated sidestep cutting movements (number of trials analyzed = 1105). According to the findings of this technical note, classification models that aim to identify the players exhibiting high or low KAM are preferable to the ones that aim to predict the actual peak KAM magnitude. The possibility of classifying high versus low KAMs during agility with good approximation (AUC 0.81-0.85) represents a step towards testing in an ecologically valid environment.
Assuntos
Aprendizado de Máquina , Futebol , Humanos , Feminino , Fenômenos Biomecânicos/fisiologia , Futebol/fisiologia , Adolescente , Articulação do Joelho/fisiologia , Lesões do Ligamento Cruzado Anterior/fisiopatologia , Movimento/fisiologia , Suporte de Carga/fisiologia , Dispositivos Eletrônicos VestíveisRESUMO
The variability and regularity of stride time may help identify individuals at a greater risk of injury during military load carriage. Wearable sensors could provide a cost-effective, portable solution for recording these measures, but establishing their validity is necessary. This study aimed to determine the agreement of several measures of stride time variability across five wearable sensors (Opal APDM, Vicon Blue Trident, Axivity, Plantiga, Xsens DOT) and force plates during military load carriage. Nineteen Australian Army trainee soldiers (age: 24.8 ± 5.3 years, height: 1.77 ± 0.09 m, body mass: 79.5 ± 15.2 kg, service: 1.7 ± 1.7 years) completed three 12-min walking trials on an instrumented treadmill at 5.5 km/h, carrying 23 kg of an external load. Simultaneously, 512 stride time intervals were identified from treadmill-embedded force plates and each sensor where linear (standard deviation and coefficient of variation) and non-linear (detrended fluctuation analysis and sample entropy) measures were obtained. Sensor and force plate agreement was evaluated using Pearson's r and intraclass correlation coefficients. All sensors had at least moderate agreement (ICC > 0.5) and a strong positive correlation (r > 0.5). These results suggest wearable devices could be employed to quantify linear and non-linear measures of stride time variability during military load carriage.