Longitudinal Tibia Stress Fracture Risk During High-Volume Training: A Multiscale Modeling Pipeline Incorporating Bone Remodeling.

Tibia stress fractures are prevalent during high-intensity training, yet a mechanistic model linking longitudinal training intensity, bone health, and long-term injury risk has yet to be demonstrated. The objective of this study was to develop and validate a multiscale model of gross and tissue level loading on the tibia including bone remodeling on a timescale of week. Peak tensile tibial strain (3517 µstrain) during 4 m/s running was below injury thresholds, and the peak anteromedial tibial strain (1248 µstrain) was 0.17 standard deviations away from the mean of reported literature values. An initial study isolated the effects of cortical density and stiffness on tibial strain during a simulated eight week training period. Tibial strains and cortical microcracking correlated with initial cortical modulus, with all simulations presenting peak anteromedial tensile strains (1047-1600 µstrain) near day 11. Average cortical densities decreased by 7-8% of their nominal value by day 11, but the overall density change was <2% by the end of the simulated training period, in line with reported results. This study demonstrates the benefits of multiscale models for investigating stress fracture risk and indicates that peak tibial strain, and thus injury risk, may increase early in a high intensity training program. Future studies could optimize training volume and recovery time to reduce injury risk during the most vulnerable training periods.

Hierarchical Validation Prevents Over-Fitting of the Neck Material Model for an Anthropomorphic Test Device Used in Underbody Blast Scenarios.

Injury due to underbody loading is increasingly relevant to the safety of the modern warfighter. To accurately evaluate injury risk in this loading modality, a biofidelic anthropomorphic test device (e.g., dummy) is required. Finite element model counterparts to the physical dummies are also useful tools in the evaluation of injury risk, but require validated constitutive material models used in the dummy. However, material model fitting can result in models that are over-fit: they match well with the data they were trained on, but do not extrapolate well to new loading scenarios. In this study, we used a hierarchical approach. Material models created from coupon-level tests were evaluated at the component level, and then verified using blinded component and whole body (WB) tests to establish a material model of the anthropomorphic test device (ATD) neck that was not over-fit. Additionally, a combined metric is introduced that incorporates the well-known correlation analysis (CORA) score with peak characteristics to holistically evaluate the material model performance. A Bergstrom Boyce material model fit to one loop of combined compression and tension experimental data performed the best within the training datasets. Its combined metric scores were 2.51 and 2.18 (max score of 3) in a constrained neck and head neck setup, respectively. In the blinded evaluation including flexed, extended, and WB simulations, similar combined scores were observed with 2.44, 2.26, and 2.60, respectively. The agreement between the combined scores in the training and validation dataset indicated that model was not over-fit and can be extrapolated into untested, but similar loading scenarios.

Combat Helmet Suspension System Stiffness Influences Linear Head Acceleration and White Matter Tissue Strains: Implications for Future Helmet Design.

Combat helmets are expected to protect the warfighter from a variety of blunt, blast, and ballistic threats. Their blunt impact performance is evaluated by measuring linear headform acceleration in drop tower tests, which may be indicative of skull fracture, but not necessarily brain injury. The current study leverages a blunt impact biomechanics model consisting of a head, neck, and helmet with a suspension system to predict how pad stiffness affects both (1) linear acceleration alone and (2) brain tissue response induced by both linear and rotational acceleration. The approach leverages diffusion tensor imaging information to estimate how pad stiffness influences white matter tissue strains, which may be representative of diffuse axonal injury. Simulation results demonstrate that a softer pad material reduces linear head accelerations for mild and moderate impact velocities, but a stiffer pad design minimizes linear head accelerations at high velocities. Conversely, white matter tract-oriented strains were found to be smallest with the softer pads at the severe impact velocity. The results demonstrate that the current helmet blunt impact testing standards' standalone measurement of linear acceleration does not always convey how the brain tissue responds to changes in helmet design. Consequently, future helmet testing should consider the brain's mechanical response when evaluating new designs.

A technique for developing CAD geometry of long bones using clinical CT data.

Computed tomography scans are a valuable tool for developing computational models of bones. The objective of this study is to present a method to generate CAD representations of long bones from clinically based CT scans. A secondary aim is to apply the method to six long bones from a sample of three individuals. Periosteal and endosteal bone surfaces were segmented and used to calculate the characteristic cortical thickness, Tc, at 1 mm increments along the bone axis. In the epiphyses where the value of Tc fell below the scanner threshold, the endosteal bone layer was replaced using literature values projected inward from the periosteal surface. On average, 74.7 ± 7.4% of the bone geometry was above the scanner cut-off and was therefore derived from the CT scan data. The thickness measurement was also compared to experimental measurements of cadaveric bone and was found to predict Tc with an error of 3.1%. This method presents a possible solution for the characterization of characteristic thickness along the length of the bone and may also aid in the development of orthopedic implant design and subject specific finite element models.

Age- and sex-specific thorax finite element model development and simulation.

OBJECTIVE: The shape, size, bone density, and cortical thickness of the thoracic skeleton vary significantly with age and sex, which can affect the injury tolerance, especially in at-risk populations such as the elderly. Computational modeling has emerged as a powerful and versatile tool to assess injury risk. However, current computational models only represent certain ages and sexes in the population. The purpose of this study was to morph an existing finite element (FE) model of the thorax to depict thorax morphology for males and females of ages 30 and 70 years old (YO) and to investigate the effect on injury risk. METHODS: Age- and sex-specific FE models were developed using thin-plate spline interpolation. In order to execute the thin-plate spline interpolation, homologous landmarks on the reference, target, and FE model are required. An image segmentation and registration algorithm was used to collect homologous rib and sternum landmark data from males and females aged 0-100 years. The Generalized Procrustes Analysis was applied to the homologous landmark data to quantify age- and sex-specific isolated shape changes in the thorax. The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant model was morphed to create age- and sex-specific thoracic shape change models (scaled to a 50th percentile male size). To evaluate the thoracic response, 2 loading cases (frontal hub impact and lateral impact) were simulated to assess the importance of geometric and material property changes with age and sex. RESULTS: Due to the geometric and material property changes with age and sex, there were observed differences in the response of the thorax in both the frontal and lateral impacts. Material property changes alone had little to no effect on the maximum thoracic force or the maximum percent compression. With age, the thorax becomes stiffer due to superior rotation of the ribs, which can result in increased bone strain that can increase the risk of fracture. For the 70-YO models, the simulations predicted a higher number of rib fractures in comparison to the 30-YO models. The male models experienced more superior rotation of the ribs in comparison to the female models, which resulted in a higher number of rib fractures for the males. CONCLUSION: In this study, age- and sex-specific thoracic models were developed and the biomechanical response was studied using frontal and lateral impact simulations. The development of these age- and sex-specific FE models of the thorax will lead to an improved understanding of the complex relationship between thoracic geometry, age, sex, and injury risk.

Quantitative Validation of a Human Body Finite Element Model Using Rigid Body Impacts.

Validation is a critical step in finite element model (FEM) development. This study focuses on the validation of the Global Human Body Models Consortium full body average male occupant FEM in five localized loading regimes-a chest impact, a shoulder impact, a thoracoabdominal impact, an abdominal impact, and a pelvic impact. Force and deflection outputs from the model were compared to experimental traces and corridors scaled to the 50th percentile male. Predicted fractures and injury severity measures were compared to evaluate the model's injury prediction capabilities. The methods of ISO/TS 18571 were used to quantitatively assess the fit of model outputs to experimental force and deflection traces. The model produced peak chest, shoulder, thoracoabdominal, abdominal, and pelvis forces of 4.8, 3.3, 4.5, 5.1, and 13.0 kN compared to 4.3, 3.2, 4.0, 4.0, and 10.3 kN in the experiments, respectively. The model predicted rib and pelvic fractures related to Abbreviated Injury Scale scores within the ranges found experimentally all cases except the abdominal impact. ISO/TS 18571 scores for the impacts studied had a mean score of 0.73 with a range of 0.57-0.83. Well-validated FEMs are important tools used by engineers in advancing occupant safety.

Use of silicone materials to simulate tissue biomechanics as related to deep tissue injury.

OBJECTIVE: Deep tissue injury (DTI) is caused by prolonged mechanical loading that disrupts blood flow and metabolic clearance. A patient simulator that mimics the biomechanical aspects of DTI initiation, stress and strain in deep muscle tissue, would be potentially useful as a training tool for pressure-relief techniques and testing platform for pressure-mitigating products. As a step toward this goal, this study evaluates the ability of silicone materials to mimic the distribution of stress in muscle tissue under concentrated loading. METHODS: To quantify the mechanical properties of candidate silicone materials, unconfined compression experiments were conducted on 3 silicone formulations (Ecoflex 0030, Ecoflex 0010, and Dragon Skin; Smooth-On, Inc, Easton, Pennsylvania). Results were fit to an Ogden hyperelastic material model, and the resulting shear moduli (G) were compared with published values for biological tissues. Indentation tests were then conducted on Ecoflex 0030 and porcine muscle to investigate silicone's ability to mimic the nonuniform stress distribution muscle demonstrates under concentrated loading. Finite element models were created to quantify stresses throughout tissue depth. Finally, a preliminary patient simulator prototype was constructed, and both deep and superficial "tissue" pressures were recorded to examine stress distribution. RESULTS: Indentation tests showed similar stress distribution trends in muscle and Ecoflex 0030, but stress magnitudes were higher in Ecoflex 0030 than in porcine muscle. All 3 silicone formulations demonstrated shear moduli within the range of published values for biological tissue. For the experimental conditions reported in this work, Ecoflex 0030 exhibited greater stiffness than porcine muscle. CONCLUSION: Indentation tests and the prototype patient simulator trial demonstrated similar trends with high pressures closest to the bony prominence with decreasing magnitude toward the interfacial surface. Qualitatively, silicone mimicked the phenomenon observed in muscle of nonuniform stress under concentrated loading. Although shear moduli were within biological ranges, stress and stiffness values exceeded those of porcine muscle. This research represents a first step toward development of a preclinical model simulating the biomechanical conditions of stress and strain in deep muscle, since local biomechanical factors are acknowledged to play a role in DTI initiation. Future research is needed to refine the capacity of preclinical models to simulate biomechanical parameters in successive tissue layers of muscle, fat, dermis, and epidermis typically intervening between bone and support surfaces, for body regions at risk for DTI.

Validation of simulated chestband data in frontal and lateral loading using a human body finite element model.

OBJECTIVE: Finite element (FE) computer models are an emerging tool to examine the thoracic response of the human body in the simulated environment. In this study, a recently developed human body model, the Global Human Body Models Consortium (GHBMC) mid-sized male, was used to examine chestband contour deformations in a frontal and lateral impact. The objective of this study was 2-fold. First, a methodology for extracting and analyzing virtual chestband data from a full-body FE model is presented. Then, this method is applied to virtual chestband data from 2 simulations to evaluate the model's performance against experimental data. METHODS: One frontal and one lateral impact case were simulated using the FE model, which was preprogrammed with upper, middle, and lower chestbands. Maximum compression was determined using established techniques. Furthermore, a quadrant-based analysis technique for the results was introduced that enabled regional comparisons between the model and the experimental data in the anterior, posterior, right, and left sections of the chestband. RESULTS: For the frontal case at 13.3 m/s, the model predicted a peak compression of 13.6 and 12.9 percent for the upper and middle chestbands. For the lateral case at 6.7 m/s, the model predicted peak compression of the upper, middle, and lower chestbands of 27.9, 26.0, and 20.4 percent. Regional analysis showed average differences at maximum deformation between the model and experiments ranging from 0.9 percent (posterior) to 6.3 percent (anterior) in the frontal case and 2.3 percent (posterior) to 10.8 percent (anterior) in the lateral case. The greatest difference between model and experimental findings was found in the anterior quadrant. CONCLUSIONS: Though this work was focused on techniques to extract and analyze chestband data from FE models, the comparative results provide further validation of the model used in this study. The results suggest the importance of evaluating comparisons between virtual and experimental chestband data on a regional basis. These data also provide the potential to correlate chestband deformations to the loading of underlying thoraco-abdominal structures. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Investigation of the mass distribution of a detailed seated male finite element model.

Accurate mass distribution in computational human body models is essential for proper kinematic and kinetic simulations. The purpose of this study was to investigate the mass distribution of a 50th percentile male (M50) full body finite element model (FEM) in the seated position. The FEM was partitioned into 10 segments, using segment planes constructed from bony landmarks per the methods described in previous research studies. Body segment masses and centers of gravity (CGs) of the FEM were compared with values found from these studies, which unlike the present work assumed homogeneous body density. Segment masses compared well to literature while CGs showed an average deviation of 6.0% to 7.0% when normalized by regional characteristic lengths. The discrete mass distribution of the FEM appears to affect the mass and CGs of some segments, particularly those with low-density soft tissues. The locations of the segment CGs are provided in local coordinate systems, thus facilitating comparison with other full body FEMs and human surrogates. The model provides insights into the effects of inhomogeneous mass on the location of body segment CGs.

Application of Radial Basis Function Methods in the Development of a 95th Percentile Male Seated FEA Model.

Human body finite element models (FEMs) are a valuable tool in the study of injury biomechanics. However, the traditional model development process can be time-consuming. Scaling and morphing an existing FEM is an attractive alternative for generating morphologically distinct models for further study. The objective of this work is to use a radial basis function to morph the Global Human Body Models Consortium (GHBMC) average male model (M50) to the body habitus of a 95th percentile male (M95) and to perform validation tests on the resulting model. The GHBMC M50 model (v. 4.3) was created using anthropometric and imaging data from a living subject representing a 50th percentile male. A similar dataset was collected from a 95th percentile male (22,067 total images) and was used in the morphing process. Homologous landmarks on the reference (M50) and target (M95) geometries, with the existing FE node locations (M50 model), were inputs to the morphing algorithm. The radial basis function was applied to morph the FE model. The model represented a mass of 103.3 kg and contained 2.2 million elements with 1.3 million nodes. Simulations of the M95 in seven loading scenarios were presented ranging from a chest pendulum impact to a lateral sled test. The morphed model matched anthropometric data to within a rootmean square difference of 4.4% while maintaining element quality commensurate to the M50 model and matching other anatomical ranges and targets. The simulation validation data matched experimental data well in most cases.

An evaluation of objective rating methods for full-body finite element model comparison to PMHS tests.

OBJECTIVE: Objective evaluation methods of time history signals are used to quantify how well simulated human body responses match experimental data. As the use of simulations grows in the field of biomechanics, there is a need to establish standard approaches for comparisons. There are 2 aims of this study. The first is to apply 3 objective evaluation methods found in the literature to a set of data from a human body finite element model. The second is to compare the results of each method, examining how they are correlated to each other and the relative strengths and weaknesses of the algorithms. METHODS: In this study, the methods proposed by Sprague and Geers (magnitude and phase error, SGM and SGP), Rhule et al. (cumulative standard deviation, CSD), and Gehre et al. (CORrelation and Analysis, or CORA, size, phase, shape, corridor) were compared. A 40 kph frontal sled test presented by Shaw et al. was simulated using the Global Human Body Models Consortium midsized male full-body finite element model (v. 3.5). Mean and standard deviation experimental data (n = 5) from Shaw et al. were used as the benchmark. Simulated data were output from the model at the appropriate anatomical locations for kinematic comparison. Force data were output at the seat belts, seat pan, knee, and foot restraints. RESULTS: Objective comparisons from 53 time history data channels were compared to the experimental results. To compare the different methods, all objective comparison metrics were cross-plotted and linear regressions were calculated. The following ratings were found to be statistically significantly correlated (P < .01): SGM and CORrelation and Analysis (CORA) size, R (2) = 0.73; SGP and CORA shape, R (2) = 0.82; and CSD and CORA's corridor factor, R (2) = 0.59. Relative strengths of the correlated ratings were then investigated. For example, though correlated to CORA size, SGM carries a sign to indicate whether the simulated response is greater than or less than the benchmark signal. A further analysis of the advantages and drawbacks of each method is discussed. CONCLUSIONS: The results demonstrate that a single metric is insufficient to provide a complete assessment of how well the simulated results match the experiments. The CORA method provided the most comprehensive evaluation of the signal. Regardless of the method selected, one primary recommendation of this work is that for any comparison, the results should be reported to provide separate assessments of a signal's match to experimental variance, magnitude, phase, and shape. Future work planned includes implementing any forthcoming International Organization for Standardization standards for objective evaluations. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Human liver finite element model validation using compressive and tensile experimental data - biomed 2013.

Motor vehicle crashes commonly result in blunt abdominal trauma. Approximately 19,000 such injuries occur each year in the United States. While finite element models of the human body are becoming an important tool for injury assessment, their reliability depends on the accuracy of the material models used. Recently, Samur et al. proposed a hyperelastic and viscoelastic material model of the liver. The aim of this study was to compare the results of a computational model using this material law to uniaxial tension and compression data from biomechanical tests on liver samples by Kemper et al. In this study, the liver samples were modeled using the finite element method. Both the tension and compression test specimen geometries were created from descriptions in the literature. Each sample was meshed using four approaches: fine hexahedral, coarse hexahedral, fine tetrahedral, and coarse tetrahedral. The average element edge lengths of the coarse and fine meshes were 5 mm and 2.5 mm respectively. The samples were loaded in both tension and compression at four rates: 0.01 strain/sec, 0.1 strain/sec, 1 strain/sec, and 10 strain/sec. For each mesh type (n=4), strain rate (n=4), and loading condition (n=2), 32 simulations in total, the results were plotted against the published experimental data. The results were quantitatively evaluated for magnitude and phase agreement with the experimental data using an objective comparison software package, CORA. The model predicted the tensile response of the liver sample more accurately than the compressive response with an average CORA size error factor of 0.66 versus 0.19 for the compressive model (1 is a perfect match). The fine tetrahedral, fine hexahedral, and coarse hexahedral meshes predicted a similar response. The worst performing mesh was the coarse tetrahedral mesh, which had an average size error factor of 8.6% higher than the fine tetrahedral simulations. The peak stress in both tension and compression varied as a function of the loading rate. Peak tensile stress increased 13% from the lower to higher loading rate, and peak compressive stress increased 0.5%. These findings show evidence that the viscoelastic behavior is captured in the model, although it is under predicted in comparison to the literature. Future work will focus on other material models that better predict the experimentally observed loading observed in the literature. Validation of the liver model’s response to compressive and tensile loading conditions across multiple rates is important to ensure accurate injury predictions when used in a full body finite element model.

Lateral impact validation of a geometrically accurate full body finite element model for blunt injury prediction.

This study presents four validation cases of a mid-sized male (M50) full human body finite element model-two lateral sled tests at 6.7 m/s, one sled test at 8.9 m/s, and a lateral drop test. Model results were compared to transient force curves, peak force, chest compression, and number of fractures from the studies. For one of the 6.7 m/s impacts (flat wall impact), the peak thoracic, abdominal and pelvic loads were 8.7, 3.1 and 14.9 kN for the model and 5.2 ± 1.1 kN, 3.1 ± 1.1 kN, and 6.3 ± 2.3 kN for the tests. For the same test setup in the 8.9 m/s case, they were 12.6, 6, and 21.9 kN for the model and 9.1 ± 1.5 kN, 4.9 ± 1.1 kN, and 17.4 ± 6.8 kN for the experiments. The combined torso load and the pelvis load simulated in a second rigid wall impact at 6.7 m/s were 11.4 and 15.6 kN, respectively, compared to 8.5 ± 0.2 kN and 8.3 ± 1.8 kN experimentally. The peak thorax load in the drop test was 6.7 kN for the model, within the range in the cadavers, 5.8-7.4 kN. When analyzing rib fractures, the model predicted Abbreviated Injury Scale scores within the reported range in three of four cases. Objective comparison methods were used to quantitatively compare the model results to the literature studies. The results show a good match in the thorax and abdomen regions while the pelvis results over predicted the reaction loads from the literature studies. These results are an important milestone in the development and validation of this globally developed average male FEA model in lateral impact.

Porohyperviscoelastic model simultaneously predicts parenchymal fluid pressure and reaction force in perfused liver.

Porohyperviscoelastic (PHVE) modeling gives a simplified continuum approximation of pore fluid behavior within the parenchyma of liver tissue. This modeling approach is particularly applicable to tissue engineering of artificial livers, where the inherent complexity of the engineered scaffolds prevents the use of computational fluid dynamics. The objectives of this study were to simultaneously predict the experimental parenchymal fluid pressure (PFP) and compression response in a PHVE liver model. The model PFP matched the experimental measurements (318 Pa) to within 1.5%. Linear regression of both phases of compression, ramp, and hold, demonstrated a strong correlation between the model and the experimental reaction force (p<0.5). The ability of this PVE model to accurately predict both fluid and solid behavior is important due to the highly vascularized nature of liver tissue and the mechanosensitivity of liver cells to solid matrix and fluid flow properties.

The effect of impactor location and velocity variation on validation of an advanced human body finite element model.

Finite Element Modeling (FEM) is increasingly used as a tool in the field of injury biomechanics. One challenge in validating human body FEMs is quantifying the effect that variability of input parameters from experiments can have on the model’s predictions. The objective of this study was to conduct a parametric study on a validation simulation of the Global Human Body Models Consortium’s 50th percentile male model. The selected case was an oblique hub impact to the thoracoabdominal region of the model’s right side. The hub impactor was a 23.4 kg cylinder, with a 15cm diameter, given an initial velocity. The location and velocity of the impactor were varied based on the reported variance of the experiments used as the basis of these simulations. The effect that these changes have on the peak force was observed. Fifteen cases were simulated, giving results for five locations and three velocities based on a nominal velocity (6.7 m/s) and placement. The nominal impactor location was 7.5 cm below the xiphoid process and 30° from lateral, as described in the literature. The nominal velocity was varied ± 2 standard deviations from the average experimental velocity. The study results indicate that there were both location-based and velocity-based dependencies. There was a 5.5% increase in peak force when increasing the velocity by 0.3 m/s and a 6.4% decrease in peak force when decreasing the velocity by 0.3 m/s. Additionally, the Force vs. Time curves of the same impactor location showed a trend of similar curve shapes. The impactor location also had an impact on the number of rib fractures predicted by the model as well as the time of the peak force. The parameters used in this study represent typical experimental variation in location and velocity and show the model is reasonably robust within range of plausible impacts.