Perceived discomfort and neuromuscular fatigue during long-duration real driving with different car seats.

INTRODUCTION: Identification of the seat features that could improve driving experience is a main issue for automotive companies. OBJECTIVE: Long duration real driving sessions were performed to assess the effect of three seats (soft-S1, firm-S2 and suspended-S3) on perceived discomfort and neuromuscular fatigue (NMF). MATERIALS & METHODS: For each seat, the muscular activity of bilateral Trapezius Descendens (TD), Erector Spinae (ES) and Multifidus (MF) muscles of twenty-one participants was recorded during real driving sessions of 3-hours each lasting approximately 3 hours and following the same itinerary. During each driving session, participants were also regularly asked to self-evaluate their level of whole-body and local discomfort. In addition, an endurance static test (EST) was performed before (ESTpre) and after (ESTpost) each driving session to assess the seat effect on physical capacity. RESULTS: Whole-body discomfort increased with driving time for all seats, but this increase became significant latter for S3. The highest scores of local discomfort occurred for neck and lower back. Contrary to S1 and S2, the duration of ESTpost was not significantly lower compared to ESTpre with the S3. Interestingly, muscular activity of S1 remained stable throughout the driving task which could be attributed to sustained muscular contraction, while muscular recruitment adjustments occurred for S2 and S3 from 1H00 of driving. This muscular compensation concerns mostly the right side for S2 and S3 but with different profiles. On the left side, the muscular adjustments concern only the MF with S2 and the ES with S3. CONCLUSION: Overall, our results demonstrated that S3 could be considered as the most suitable seat to delay discomfort and NMF appearance.

Influence of car seat firmness on seat pressure profiles and perceived discomfort during prolonged simulated driving.

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.

Car seat impact on driver's sitting behavior and perceived discomfort during prolonged real driving on varied road types.

Prolonged driving under real conditions can entail discomfort linked to driving posture, seat design features, and road properties like whole-body vibrations (WBV). This study evaluated the effect of three different seats (S1 = soft; S2 = firm; S3 = soft with suspension system) on driver's sitting behavior and perceived discomfort on different road types in real driving conditions. Twenty-one participants drove the same 195 km itinerary alternating highway, city, country, and mountain segments. Throughout the driving sessions, Contact Pressure (CP), Contact Surface (CS), Seat Pressure Distribution Percentage (SPD%) and Repositioning Movements (RM) were recorded via two pressure mats installed on seat cushion and backrest. Moreover every 20 minutes, participants rated their whole-body and local discomfort. While the same increase in whole-body discomfort with driving time was observed for all three seats, S3 limited local perceived discomfort, especially in buttocks, thighs, neck, and upper back. The pressure profiles of the three seats were similar for CP, CS and RM on the backrest but differed on the seat cushion. The soft seats (S1 & S3) showed better pressure distribution, with lower SPD% than the firm seat (S2). All three showed highest CP and CS under the thighs. Road type also affected both CP and CS of all three seats, with significant differences appearing between early city, highway and country segments. In the light of these results, automotive manufacturers could enhance seat design for reduced driver discomfort by combining a soft seat cushion to reduce pressure peaks, a firm backrest to support the trunk, and a suspension system to minimize vibrations.

Neuromuscular fatigue profiles depends on seat feature during long duration driving on a static simulator.

Prolonged driving could induce neuromuscular fatigue and discomfort since drivers have little opportunity to adjust their position. However, better car seat design could play a major role in limiting these effects. This study compared the effect of two different seats (S - soft and F - firm) on neuromuscular fatigue and driver's perceived discomfort during prolonged driving, also assessing the effect of different road types on neuromuscular activity. Twenty participants performed two 3-h driving sessions, one for each seat, on a static simulator. Every 20 min, participants self-evaluated their level of whole-body and individual body-area discomfort. Surface electromyography (sEMG) was recorded for eight muscles including Trapezius descendens (TD), Erector spinae longissimus (ESL), Multifidus (MF), Vastus lateralis (VL) and Tibialis anterior (TA) throughout the driving sessions. Moreover, an endurance static test (EST) was performed prior to and after each driving session. Whole-body discomfort increased with time with both seats, but no difference in discomfort scores was observed between seats throughout the driving sessions. The highest discomfort scores were for neck and lower back areas with both seats. Neuromuscular fatigue was revealed by a shorter endurance time in post-driving EST for both seats. EMG recordings showed different neuromuscular fatigue profiles for the two seats, with earlier onset of fatigue for S. Despite the lack of difference in perceived discomfort level, the two seats have different impacts: the softness of S induces greater activity of the lower back muscles, while F offers greater support for the lower back.

Total Knee Arthroplasty with a Ti6Al4V/PEEK Prosthesis on an Osteoarthritis Rat Model: Behavioral and Neurophysiological Analysis.

Arthroplasty is a surgical procedure to restore the function of the joint of patient suffering from knee osteoarthritis. However, postoperative functional deficits are reported even after a rehabilitation program. In order to determine the origin of functional deficits of patient suffering from knee osteoarthritis and total knee arthroplasty, we developed a rodent model including a chemically-induced-osteoarthritis and designed a knee prosthesis (Ti6Al4V/PEEK) biomechanically and anatomically adapted to rat knee joint. Dynamic Weight-Bearing, gait kinematics, H-reflex from vastus medialis muscle and activities from metabosensitive III and IV afferent fibers in femoral nerve were assessed at 1 and 3 months post-surgery. Results indicate that knee osteoarthritis altered considerably the responses of afferent fibers to their known activators (i.e., lactic acid and potassium chloride) and consequently their ability to modulate the spinal sensorimotor loop, although, paradoxically, motor deficits seemed relatively light. On the contrary, results indicate that, after the total knee arthroplasty, the afferent responses and the sensorimotor function were slightly altered but that motor deficits were more severe. We conclude that neural changes attested by the recovery of the metabosensitive afferent activity and the sensorimotor loop were induced when a total knee replacement was performed and that these changes may disrupt or delay the locomotor recovery.

Biocompatibility of four common orthopedic biomaterials following neuroelectromyostimulation: An in-vivo study.

Despite the worldwide high prevalence of total joint arthroplasty (TJA), life expectancy of prosthesis remains limited by mechanical and chemical constraint which promote wear debris production, surrounding tissues damage and finally prosthesis loosening. Such results could be amplified by neuro-myoelectrostimulation (NMES; widely used to reduce neuromuscular deficits observed following TJA surgery). It was previously described in an in vivo experiment that interactions between NMES and Ti6Al4V implant are deleterious for both implant and surrounding muscles. The purpose of the present study was to compare the biocompatibility of four common orthopedic biomaterials, two metallic (Ti6Al4V, CrCo) and two nonmetallic (PEEK, Al2 O3 ) alloys, fixed on rat tibial crest in which the surrounding muscles were electrostimulated. Muscle cell death rate was not found significantly increased, with or without electrical stimulation for nonmetallic implants. Contrary to Ti6Al4V alloy, the CrCo implant did not induce destruction of the surrounding muscle. However, cell viability decreased for both metallic alloys when NMES was applied but within a greater significant extent for Ti6Al4V implant. Otherwise, when NMES was applied, implant-to-bone adhesion significantly decreased for Ti6Al4V while no significant difference was found for PEEK, Al2 O3 , and CrCo. Statistical analyses reveal also a lesser adhesion strength for Ti6Al4V compared with CrCo when NMES was applied. Selecting the most suitable material in term of biocompatibility remains a major concern and non-metallic materials seems to be more appropriated in regard to electrical currents used for post TJA care. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1156-1164, 2018.

Biocompatibility of Four Common Orthopedic Biomaterials Following a High-Salt Diet: An In Vivo Study.

Nowadays, salt consumption appears to be drastically above the recommended level in industrialized countries. The health consequences of this overconsumption are heavy since high-salt intake induces cardiovascular disease, kidney dysfunction, and stroke. Moreover, harmful interaction may also occur with orthopaedic devices because overconsumption of salt reinforces the corrosive aspect of biological tissues and favors bone resorption process. In the present study, we aimed to assess the in vivo effect of three weeks of a high-salt diet, associated (or not) with two weeks of the neuro-myoelectrostimulation (NMES) rehabilitation program on the biocompatibility of four biomaterials used in the manufacture of arthroplasty implants. Thus, two non-metallic (PEEK and Al2O3) and two metallic (Ti6Al4V and CrCo) compounds were implanted in the rat tibial crest, and the implant-to-bone adhesion and cell viability of two surrounded muscles, the Flexor Digitorum (FD) and Tibialis Anterior (TA), were assessed at the end of the experiment. Results indicated lower adhesion strength for the PEEK implant compared to other biomaterials. An effect of NMES and a high-salt diet was only identified for Al2O3 and Ti6Al4V implants, respectively. Moreover, compared to a normal diet, a high-salt diet induced a higher number of dead cells on both muscles for all biomaterials, which was further increased for PEEK, Al2O3, and CrCo materials with NMES application. Finally, except for Ti6Al4V, NMES induced a higher number of dead cells in the directly stimulated muscle (FD) compared to the indirectly stimulated one (TA). This in vivo experiment highlights the potential harmful effect of a high-salt diet for people who have undergone arthroplasty, and a rehabilitation program based on NMES.

Titanium Implant Impairment and Surrounding Muscle Cell Death Following High-Salt Diet: An In Vivo Study.

AIM OF THE STUDY: High-salt consumption has been widely described as a risk factor for cardiovascular, renal and bone functions. In the present study, the extent to which high-salt diet could influence Ti6Al4V implant surface characteristic, its adhesion to rat tibial crest, and could modify muscle cell viability of two surrounding muscles, was investigated in vivo. These parameters have also been assessed following a NMES (neuro-myoelectrostimulation) program similar to that currently used in human care following arthroplasty. RESULTS: After a three-week diet, a harmful effect on titanium implant surface and muscle cell viability was noted. This is probably due to salt corrosive effect on metal and then release of toxic substance around biologic tissue. Moreover, if the use of NMES with high-salt diet induced muscles damages, the latter were higher when implant was added. Unexpectedly, higher implant-to-bone adhesion was found for implanted animals receiving salt supplementation. CONCLUSION: Our in vivo study highlights the potential dangerous effect of high-salt diet in arthroplasty based on titanium prosthesis. This effect appears to be more important when high-salt diet is combined with NMES.

Titanium implant impairment and surrounding muscle cell death following neuro-myoelectrostimulation: An in vivo study.

Electrical currents have deleterious effects on biomedical metallic implants. However, following arthroplasty, neuro-myoelectrostimulation (NMES) is often used in patient rehabilitation. Such a rehabilitation technique could compromise patient recovery through deleterious effects on metallic alloys and biological tissues. The purpose of our study was to assess the effects of NMES on a Ti6Al4V implant placed in a rat tibial crest and the surrounding muscle tissues. This in vivo study allowed to bring to the fore the prosthesis behavior under mechanical and electromagnetic loads induced by NEMS stimulation. After 3 weeks, implant-to-bone adhesion significantly decreased in stimulated animals compared with nonstimulated animals. Surface mapping indicated titanium implant degradation after NMES. Furthermore, NMES alone did not induce muscle damage contrary to that found in implanted animals. The muscle damage rate was significantly higher in implanted and stimulated animals compared with implanted-only animals. It seems obvious that rehabilitation programs using the NMES technique could induce early deterioration of biomaterial employed for surgical implants. Clinicians should reconsider the use of NMES as a rehabilitation technique for patients with titanium prostheses.