Porcine computational modeling to investigate developmental dysplasia of the hip.

While it is well-established that early detection and initiation of treatment of developmental dysplasia of the hip (DDH) is crucial to successful clinical outcomes, research on the mechanics of the hip joint during healthy and pathological hip development in infants is limited. Quantification of mechanical behavior in both the healthy and dysplastic developing joints may provide insight into the causes of DDH and facilitate innovation in treatment options. In this study, subject-specific three-dimensional finite element models of two pigs were developed: one healthy pig and one pig with induced dysplasia in the right hindlimb. The objectives of this study were: (1) to characterize mechanical behavior in the acetabular articular cartilage during a normal walking cycle by analyzing six metrics: contact pressure, contact area, strain energy density, von Mises stress, principal stress, and principal strain; and (2) to quantify the effect on joint mechanics of three anatomic abnormalities previously identified as related to DDH: variation in acetabular coverage, morphological changes in the femoral head, and changes in the articular cartilage. All metrics, except the contact area, were elevated in the dysplastic joint. Morphological changes in the femoral head were determined to be the most significant factors in elevating contact pressure in the articular cartilage, while the effects of acetabular coverage and changes in the articular cartilage were less significant. The quantification of the pathomechanics of DDH in this study can help identify key mechanical factors that restore normal hip development and can lead to mechanics-driven treatment options.

Mechanical environment influences muscle activity during infant rolling.

An infant's musculoskeletal and motor development is largely affected by their environment. Understanding how different mechanical environments affect an infant's movements and muscle use is necessary to inform the juvenile products industry and reduce incidents involving inclined nursery products each year. The purpose of this study was to determine how the coordinated movements and corresponding muscle activation patterns are affected by different mechanical environments, specifically the back incline angle. Thirty-eight healthy infants (age: 6.5 ± 0.7 months; 23 M/15 F) were enrolled in this IRB-approved in-vivo biomechanics study. Surface electromyography sensors recorded muscle activity of the erector spinae, abdominal muscles, quadriceps, and hamstrings while infants rolled in five different mechanical environments: a flat surface and four device configurations representing a range of inclines infants are commonly exposed to. Coordinated movements were determined using video. In all configurations featuring an inclined seatback angle, infants experienced significantly higher erector spinae muscle activation and significantly lower abdominal muscle activation compared to the flat surface. Infants also exhibited a different coordinated movement featuring spinal extension and a pelvic thrust in the inclined device configurations that was not previously observed on the flat surface alone. Understanding how infants coordinate their movements and use their muscles during rolling in different inclined environments provides more insight into motor development and may inform the juvenile products industry. Many factors impact an infant's movements, therefore future work should explore how other environmental interactions influence an infant's movements and muscle activation, particularly for rolling.

How do babies roll? Identifying the coordinated movements of infant rolling through video compared to laboratory techniques.

BACKGROUND: Rolling is an important developmental milestone for infants where identifying the coordinated movement patterns could facilitate the early identification of motor development delays. Current methods for identifying coordinated movements of rolling are limited to a laboratory setting and not feasible for clinicians. OBJECTIVE: To develop video-based methods in which six coordinated movements, previously defined through motion capture, can be identified through video alone. METHODS: Forty-five videos of sixteen healthy infants achieving a roll were used to develop the video-based methodology and twenty-four videos had corresponding motion capture data used for validation. Four raters comprised of researchers and a clinician identified rolling coordination using the new video-based methods. A Fleiss' Kappa statistical test determined the inter- and intra-rater reliability of agreement for the new methodology and compared it to motion capture. RESULTS: The comparison of the motion capture and video-based methods resulted in substantial agreement. The video-based methods inter- and intra-rater reliability were substantial and almost perfect, respectively. CONCLUSIONS: We developed reliable methodology to accurately identify the coordinated movements of infant rolling using only 2D video. This methodology will allow researchers to reliably define coordinated movements of infants through video alone and may assist clinicians in identifying possible motor development delays and disorders.

Muscle activation and coordinated movements of infant rolling.

Rolling is a critical step of infant development, encouraging muscle coordination and enabling independent exploration. Understanding muscle activity during infant rolling movements on a flat surface is necessary to more fully characterize how the rolling milestone is achieved. The purpose of this study was to determine infants' muscle activation throughout roll initiation for six previously established coordinated movements. Thirty-eight healthy infants (age: 6.5 ± 0.7 months; 23M/15F) were enrolled in this IRB-approved in-vivo biomechanics study. Surface electromyography sensors recorded muscle utilization from the erector spinae, abdominal muscles, quadriceps, and hamstrings while infants rolled. Each rolling movement was categorized as one of six roll types, and the mean muscle activity was analyzed. All roll types required initial activation of all measured muscle groups. Movements featuring axial rotation of the torso relative to the pelvis required highly active erector spinae muscles. Movements featuring trunk and hip flexion required highly active abdominal muscles. Infants used distinct coordinated muscle activations to achieve the six different roll types on a flat surface. A foundational understanding of the different muscle activation patterns required during infant rolling will provide crucial insight into motor development. This study quantified muscle coordination required of infants to achieve rolling on a firm flat surface. Previous research indicates that the mechanical environment in which an infant is placed impacts muscle activity and body position during normal lying. Therefore, future work should explore if mechanical environments that differ from a flat and firm surface also influence these coordinated movements and muscle activations.