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1.
IEEE Trans Biomed Eng ; PP2022 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-35239473

RESUMO

Joint tissue mechanics (e.g., stress and strain) are believed to have a major involvement in the onset and progression of musculoskeletal disorders, e.g., knee osteoarthritis (KOA). Accordingly, considerable efforts have been made to develop musculoskeletal finite element (MS-FE) models to estimate highly detailed tissue mechanics that predict cartilage degeneration. However, creating such models is time-consuming and requires advanced expertise. This limits these complex, yet promising MS-FE models to research applications with few participants and makes the models impractical for clinical assessments. Also, these previously developed MS-FE models have not been used to assess activities other than gait. This study introduces and verifies a semi-automated rapid state-of-the-art MS-FE modeling and simulation toolbox incorporating an electromyography- (EMG) assisted MS model and a muscle-force driven FE model of the knee with fibril-reinforced poro(visco)elastic cartilages and menisci. To showcase the usability of the pipeline, we estimated joint- and tissue-level knee mechanics in 15 KOA individuals performing different daily activities. The pipeline was verified by comparing the estimated muscle activations and joint mechanics to existing experimental data. To determine the importance of EMG-assisted MS approach, results were compared to those from the same FE models but driven by static-optimization-based MS models. The EMG-assisted MS-FE pipeline bore a closer resemblance to experiments compared to the static-optimization-based MS-FE pipeline. Importantly, the developed pipeline showed great potential as a rapid MS-FE analysis toolbox to investigate multiscale knee mechanics during different activities of individuals with KOA. The template FE model of the study is freely available here.

2.
Sci Rep ; 12(1): 3599, 2022 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-35246590

RESUMO

Preparing children with cerebral palsy prior to gait analysis may be a challenging and time-intensive task, especially when large number of sensors are involved. Collecting minimum number of electromyograms (EMG) and yet providing adequate information for clinical assessment might improve clinical workflow. The main goal of this study was to develop a method to estimate activation patterns of lower limb muscles from EMG measured from a small set of muscles in children with cerebral palsy. We developed and implemented a muscle synergy extrapolation method able to estimate the full set of lower limbs muscle activation patterns from only three experimentally measured EMG. Specifically, we extracted a set of hybrid muscle synergies from muscle activation patterns of children with cerebral palsy and their healthy counterparts. Next, those muscle synergies were used to estimate activation patterns of muscles, which were not initially measured in children with cerebral palsy. Two best combinations with three (medial gastrocnemius, semi membranous, and vastus lateralis) and four (lateral gastrocnemius, semi membranous, sartorius, and vastus medialis) experimental EMG were able to estimate the full set of 10 muscle activation patterns with mean (± standard deviation) variance accounted for of 79.93 (± 9.64)% and 79.15 (± 6.40)%, respectively, using only three muscle synergies. In conclusion, muscle activation patterns of unmeasured muscles in children with cerebral palsy can be estimated from EMG measured from three to four muscles using our muscle synergy extrapolation method. In the future, the proposed muscle synergy-based method could be employed in gait clinics to minimise the required preparation time.


Assuntos
Paralisia Cerebral , Criança , Eletromiografia/métodos , Marcha/fisiologia , Análise da Marcha , Humanos , Músculo Esquelético/fisiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-35286263

RESUMO

Tissue-level mechanics (e.g., stress and strain) are important factors governing tissue remodeling and development of knee osteoarthritis (KOA), and hence, the success of physical rehabilitation. To date, no clinically feasible analysis toolbox has been introduced and used to inform clinical decision making with subject-specific in-depth joint mechanics of different activities. Herein, we utilized a rapid state-of-the-art electromyography-assisted musculoskeletal finite element analysis toolbox with fibril-reinforced poro(visco)elastic cartilages and menisci to investigate knee mechanics in different activities. Tissue mechanical responses, believed to govern collagen damage, cell death, and fixed charge density loss of proteoglycans, were characterized within 15 patients with KOA while various daily activities and rehabilitation exercises were performed. Results showed more inter-participant variation in joint mechanics during rehabilitation exercises compared to daily activities. Accordingly, the devised workflow may be used for designing subject-specific rehabilitation protocols. Further, results showed the potential to tailor rehabilitation exercises, or assess capacity for daily activity modifications, to optimally load knee tissue, especially when mechanically-induced cartilage degeneration and adaptation are of interest.


Assuntos
Cartilagem Articular , Fenômenos Biomecânicos , Cartilagem Articular/metabolismo , Eletromiografia , Análise de Elementos Finitos , Humanos , Articulação do Joelho/fisiologia , Proteoglicanas/metabolismo , Estresse Mecânico
4.
J Biomech ; 135: 111019, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35248802

RESUMO

A better understanding of deep hip muscle function is needed to establish whether retraining and strengthening these muscles is a worthwhile target for rehabilitation. This study aimed to determine the contribution of the deep hip muscles to the direction of hip loading in the acetabulum. Hip contact forces were calculated during walking and squatting for 12 participants (age: 24 ± 4 yrs, 4 females) using electromyography-informed neuromusculoskeletal modelling. Models were configured with different deep hip muscle activation levels: deep hip muscles (piriformis, obturator internus and externus, gemellus superior and inferior, and quadratus femoris) informed by intramuscular electromyography measurements (i.e., normal activation; assisted activation) and simulated with zero (no activation) or maximal (maximal activation) activation. The angle between the hip contact force and the vector from the femoral head to the acetabular center (hip contact force angle) was calculated for all configurations, where lower angles equated to hip loading directed towards the acetabular center. The position and spread of acetabular loading during both tasks were calculated for all configurations and compared using a within-participant analysis of variance via statistical parametric mapping (P < 0.05). Maximal activation resulted in lower hip contact force angles and more anterior-inferior oriented, albeit a slightly reduced, spread of acetabular loading compared to assisted activation and no activation. Results suggest that, if activated maximally, the deep hip muscles can change the direction of hip loading away from commonly damaged areas of acetabular cartilage. Targeted training of these muscles may be relevant for individuals with hip pathology who present with unfavorable regional loading and/or cartilage lesions.


Assuntos
Quadril , Coxa da Perna , Acetábulo , Adulto , Eletromiografia , Feminino , Quadril/fisiologia , Articulação do Quadril/fisiologia , Humanos , Masculino , Músculo Esquelético/fisiologia , Coxa da Perna/fisiologia , Adulto Jovem
5.
J Appl Physiol (1985) ; 132(4): 956-965, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35142563

RESUMO

A better understanding of the strains experienced by the Achilles tendon during commonly prescribed exercises and locomotor tasks is needed to improve efficacy of Achilles tendon training and rehabilitation programs. The aim of this study was to estimate in vivo free Achilles tendon strain during selected rehabilitation, locomotor, jumping, and landing tasks. Sixteen trained runners with no symptoms of Achilles tendinopathy participated in this study. Personalized free Achilles tendon moment arm and force-strain curve were obtained from imaging data and used in conjunction with motion capture and surface electromyography to estimate free Achilles tendon strain using electromyogram-informed neuromusculoskeletal modeling. There was a strong correspondence between Achilles tendon force estimates from the present study and experimental data reported in the literature (R2 > 0.85). The average tendon strain was highest for maximal hop landing (8.8 ± 1.6%), lowest for walking at 1.4 m/s (3.1 ± 0.8%), and increased with locomotor speed during running (run 3.0 m/s: 6.5 ± 1.6%; run 5.0 m/s: 7.9 ± 1.7%) and during heel rise exercise with added mass (BW: 5.8 ± 1.3%; 1.2 BW: 6.9 ± 1.7%). The peak tendon strain was highest during running (5 m/s: 13.7 ± 2.5%) and lowest during walking (1.4 m/s: 7 ± 1.8%). Overall findings provide a preliminary evidence base for exercise selection to maximize anabolic tendon remodeling during training and rehabilitation of the Achilles tendon.NEW & NOTEWORTHY Our work combines medical imaging and electromyogram-informed neuromusculoskeletal modeling data to estimate free Achilles tendon strain during selected rehabilitation, locomotor, jumping, and landing tasks in trained middle-distance runners. These data may potentially be used to inform Achilles tendon training and rehabilitation to maximize anabolic tendon remodeling.


Assuntos
Tendão do Calcâneo , Corrida , Tendinopatia , Traumatismos dos Tendões , Fenômenos Biomecânicos , Humanos , Caminhada
6.
IEEE Trans Biomed Eng ; 69(3): 1133-1140, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34559628

RESUMO

OBJECTIVE: This study determined the contribution of the deep hip muscles to hip stability. METHODS: Hip stability was defined as rotational hip stiffness in the sagittal plane, which was calculated for walking trials for 12 participants via an electromyography (EMG)-informed neuromusculoskeletal model which included all 22 hip spanning muscles. Three model configurations which differed in deep hip muscle excitations but had identical excitations for all other muscles were compared: (1) deep hip muscles informed by intramuscular EMG measurements (assisted activation); (2) deep hip muscles with simulated zero activation (no activation); (3) deep hip muscles with simulated maximal activation (maximal activation). Sagittal plane rotational hip stiffness across the gait cycle was compared between the three model configurations using a within-participant analysis of variance via statistical parametric mapping (p < 0.05). RESULTS: Compared to the assisted activation configuration, hip stiffness (mean (95% confidence interval)) was 0.8% (0.7 to 0.9) lower in the no activation configuration, and 3.2% (3.0 to 3.4) higher in the maximal activation configuration. CONCLUSION: Regardless of activation level, deep hip muscles contributed little to sagittal plane rotational hip stiffness, which casts doubt on their assumed function as hip stabilizers. SIGNIFICANCE: The merit of targeted deep hip muscle strengthening to improve hip stability in rehabilitation programs remains unclear.


Assuntos
Articulação do Quadril , Caminhada , Fenômenos Biomecânicos , Eletromiografia , Marcha/fisiologia , Articulação do Quadril/fisiologia , Humanos , Músculo Esquelético/fisiologia , Caminhada/fisiologia
7.
J Biomech Eng ; 144(3)2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34557891

RESUMO

Knowledge of neck muscle activation strategies before sporting impacts is crucial for investigating mechanisms of severe spinal injuries. However, measurement of muscle activations during impacts is experimentally challenging and computational estimations are not often guided by experimental measurements. We investigated neck muscle activations before impacts with the use of electromyography (EMG)-assisted neuromusculoskeletal models. Kinematics and EMG recordings from four major neck muscles of a rugby player were experimentally measured during rugby activities. A subject-specific musculoskeletal model was created with muscle parameters informed from MRI measurements. The model was used in the calibrated EMG-informed neuromusculoskeletal modeling toolbox and three neural solutions were compared: (i) static optimization (SO), (ii) EMG-assisted (EMGa), and (iii) MRI-informed EMG-assisted (EMGaMRI). EMGaMRI and EMGa significantly (p < 0.01) outperformed SO when tracking cervical spine net joint moments from inverse dynamics in flexion/extension (RMSE = 0.95, 1.14, and 2.32 N·m) but not in lateral bending (RMSE = 1.07, 2.07, and 0.84 N·m). EMG-assisted solutions generated physiological muscle activation patterns and maintained experimental cocontractions significantly (p < 0.01) outperforming SO, which was characterized by saturation and nonphysiological "on-off" patterns. This study showed for the first time that physiological neck muscle activations and cervical spine net joint moments can be estimated without assumed a priori objective criteria before impacts. Future studies could use this technique to provide detailed initial loading conditions for theoretical simulations of neck injury during impacts.


Assuntos
Modelos Biológicos , Músculo Esquelético , Fenômenos Biomecânicos , Eletromiografia , Articulações/fisiologia , Músculo Esquelético/fisiologia
8.
PLoS One ; 16(11): e0256528, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34797871

RESUMO

Rupture of the scapholunate interosseous ligament can cause the dissociation of scaphoid and lunate bones, resulting in impaired wrist function. Current treatments (e.g., tendon-based surgical reconstruction, screw-based fixation, fusion, or carpectomy) may restore wrist stability, but do not address regeneration of the ruptured ligament, and may result in wrist functional limitations and osteoarthritis. Recently a novel multiphasic bone-ligament-bone scaffold was proposed, which aims to reconstruct the ruptured ligament, and which can be 3D-printed using medical-grade polycaprolactone. This scaffold is composed of a central ligament-scaffold section and features a bone attachment terminal at either end. Since the ligament-scaffold is the primary load bearing structure during physiological wrist motion, its geometry, mechanical properties, and the surgical placement of the scaffold are critical for performance optimisation. This study presents a patient-specific computational biomechanical evaluation of the effect of scaffold length, and positioning of the bone attachment sites. Through segmentation and image processing of medical image data for natural wrist motion, detailed 3D geometries as well as patient-specific physiological wrist motion could be derived. This data formed the input for detailed finite element analysis, enabling computational of scaffold stress and strain distributions, which are key predictors of scaffold structural integrity. The computational analysis demonstrated that longer scaffolds present reduced peak scaffold stresses and a more homogeneous stress state compared to shorter scaffolds. Furthermore, it was found that scaffolds attached at proximal sites experience lower stresses than those attached at distal sites. However, scaffold length, rather than bone terminal location, most strongly influences peak stress. For each scaffold terminal placement configuration, a basic metric was computed indicative of bone fracture risk. This metric was the minimum distance from the bone surface to the internal scaffold bone terminal. Analysis of this minimum bone thickness data confirmed further optimisation of terminal locations is warranted.


Assuntos
Ligamentos Articulares/cirurgia , Osso Semilunar/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Osso Escafoide/cirurgia , Articulação do Punho/cirurgia , Fenômenos Biomecânicos/fisiologia , Análise de Elementos Finitos , Humanos , Modelos Biológicos , Movimento/fisiologia , Procedimentos Ortopédicos
9.
BMC Musculoskelet Disord ; 22(1): 909, 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34711188

RESUMO

BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) together with concomitant meniscal injury are risk factors for the development of tibiofemoral (TF) osteoarthritis (OA), but the potential effect on the patellofemoral (PF) joint is unclear. The aim of this study was to: (i) investigate change in patellar cartilage morphology in individuals 2.5 to 4.5 years after ACLR with or without concomitant meniscal pathology and in healthy controls, and (ii) examine the association between baseline patellar cartilage defects and patellar cartilage volume change. METHODS: Thirty two isolated ACLR participants, 25 ACLR participants with combined meniscal pathology and nine healthy controls underwent knee magnetic resonance imaging (MRI) with 2-year intervals (baseline = 2.5 years post-ACLR). Patellar cartilage volume and cartilage defects were assessed from MRI using validated methods. RESULTS: Both ACLR groups showed patellar cartilage volume increased over 2 years (p < 0.05), and isolated ACLR group had greater annual percentage cartilage volume increase compared with controls (mean difference 3.6, 95% confidence interval (CI) 1.0, 6.3%, p = 0.008) and combined ACLR group (mean difference 2.2, 95% CI 0.2, 4.2%, p = 0.028). Patellar cartilage defects regressed in the isolated ACLR group over 2 years (p = 0.02; Z = - 2.33; r = 0.3). Baseline patellar cartilage defect score was positively associated with annual percentage cartilage volume increase (Regression coefficient B = 0.014; 95% CI 0.001, 0.027; p = 0.03) in the pooled ACLR participants. CONCLUSIONS: Hypertrophic response was evident in the patellar cartilage of ACLR participants with and without meniscal pathology. Surprisingly, the increase in patellar cartilage volume was more pronounced in those with isolated ACLR. Although cartilage defects stabilised in the majority of ACLR participants, the severity of patellar cartilage defects at baseline influenced the magnitude of the cartilage hypertrophic response over the subsequent ~ 2 years.


Assuntos
Lesões do Ligamento Cruzado Anterior , Cartilagem , Humanos , Articulação do Joelho , Imageamento por Ressonância Magnética , Patela/diagnóstico por imagem , Patela/cirurgia , Estudos Prospectivos
10.
Am J Sports Med ; 49(12): 3322-3334, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34494904

RESUMO

BACKGROUND: Rates of anterior cruciate ligament (ACL) rupture in young people have increased by >70% over the past two decades. Adolescent and young adult females are at higher risk of ACL injury as compared with their prepubertal counterparts. PURPOSE: To determine ACL loading during a standardized drop-land-lateral jump in females at different stages of pubertal maturation. STUDY DESIGN: Controlled laboratory study. METHODS: On the basis of the Tanner classification system, 19 pre-, 19 early-/mid-, and 24 late-/postpubertal females performed a standardized drop-land-lateral jump while 3-dimensional body motion, ground-reaction forces, and surface electromyography data were acquired. These data were used to model external biomechanics, lower limb muscle forces, and knee contact forces, which were subsequently used in a validated computational model to estimate ACL loading. Statistical parametric mapping analysis of variance was used to compare ACL force and its causal contributors among the 3 pubertal maturation groups during stance phase of the task. RESULTS: When compared with pre- and early-/midpubertal females, late-/postpubertal females had significantly higher ACL force with mean differences of 471 and 356 N during the first 30% and 48% to 85% of stance, and 343 and 274 N during the first 24% and 59% to 81% of stance, respectively, which overlapped peaks in ACL force. At the point of peak ACL force, contributions from sagittal and transverse plane loading mechanisms to ACL force were higher in late-/postpubertal compared with pre- and early-/midpubertal groups (medium effect sizes from 0.44 to 0.77). No differences were found between pre- and early-/midpubertal groups in ACL force or its contributors. CONCLUSION: The highest ACL forces were observed in late-/postpubertal females, consistent with recently reported rises of ACL injury rates in females aged 15 to 19 years. It is important to quantify ACL force and its contributors during dynamic tasks to advance our understanding of the loading mechanism and thereby provide guidance to injury prevention. CLINICAL RELEVANCE: Growth of ACL volume plateaus around 10 years of age, before pubertal maturation, meaning that a late-/postpubertal female could have an ACL of similar size to their less mature counterparts. However, late-/postpubertal females have higher body mass requiring higher muscle forces to accelerate the body during dynamic tasks, which may increase ACL loading. Thus, if greater forces develop in these females, in part because of their increased body mass, these higher forces will be applied to an ACL that is not proportionally larger. This may partially explain the higher rates of ACL injury in late-/postpubertal females.


Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior , Adolescente , Fenômenos Biomecânicos , Feminino , Humanos , Joelho , Articulação do Joelho
11.
Hip Int ; : 11207000211038550, 2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34424780

RESUMO

BACKGROUND: Bony morphology is central to the pathomechanism of femoroacetabular impingement syndrome (FAIS), however isolated radiographic measures poorly predict symptom onset and severity. More comprehensive morphology measurement considered together with patient factors may better predict symptom presentation. This study aimed to determine the morphological parameter(s) and patient factor(s) associated with symptom age of onset and severity in FAIS. METHODS: 99 participants (age 32.9 ± 10.5 years; body mass index (BMI 24.3 ± 3.1 kg/m2; 42% females) diagnosed with FAIS received standardised plain radiographs and magnetic resonance scans. Alpha angle in four radial planes (superior to anterior), acetabular version (AV), femoral torsion, lateral centre-edge, anterior centre-edge (ACEA) and femoral neck-shaft angles were measured. Age of symptom onset (age at presentation minus duration of symptoms), international Hip Outcome Tool-33 (iHOT-33) and modified UCLA activity scores were recorded. Backward stepwise regression assessed morphological parameters and patient factors (age, sex, BMI, symptom duration, annual income, private/public healthcare system accessed) to determine variables independently associated with onset age and iHOT-33 score. RESULTS: Earlier symptom onset was associated with larger superoanterior alpha angle (p = 0.007), smaller AV (p = 0.023), lower BMI (p = 0.010) and public healthcare system access (p = 0.041) (r2 = 0.320). Worse iHOT-33 score was associated with smaller ACEA (p = 0.034), female sex (p = 0.040), worse modified UCLA activity score (p = 0.010) and public healthcare system access (p < 0.001) (r2 = 0.340). CONCLUSIONS: Age of symptom onset was chiefly predicted by femoral and acetabular bony morphology measures, whereas symptom severity predominantly by patient factors. Factors measured explained a small amount of variance in the data; additional unmeasured factors may be more influential.

12.
Med Sci Sports Exerc ; 53(6): 1235-1244, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33731661

RESUMO

INTRODUCTION: This study determined anterior cruciate ligament (ACL) force and its contributors during a standardized drop-land-lateral jump task using a validated computational model. METHODS: Three-dimensional whole-body kinematics, ground reaction forces, and muscle activation patterns from eight knee-spanning muscles were collected during dynamic tasks performed by healthy recreationally active females (n = 24). These data were used in a combined neuromusculoskeletal and ACL force model to determine lower limb muscle and ACL forces. RESULTS: Peak ACL force (2.3 ± 0.5 bodyweight) was observed at ~14% of stance during the drop-land-lateral jump. The ACL force was primarily generated through the sagittal plane, and muscle was the dominant source of ACL loading. The main ACL antagonists (i.e., loaders) were the gastrocnemii and quadriceps, whereas the hamstrings were the main ACL agonists (i.e., supporters). CONCLUSION: Combining neuromusculoskeletal and ACL force models, the roles of muscle in ACL loading and support were determined during a challenging motor task. Results highlighted the importance of the gastrocnemius in ACL loading, which could be considered more prominently in ACL injury prevention and rehabilitation programs.


Assuntos
Ligamento Cruzado Anterior/fisiologia , Joelho/fisiologia , Músculo Esquelético/fisiologia , Adolescente , Lesões do Ligamento Cruzado Anterior/prevenção & controle , Lesões do Ligamento Cruzado Anterior/reabilitação , Fenômenos Biomecânicos , Simulação por Computador , Eletromiografia , Teste de Esforço , Feminino , Músculos Isquiossurais/fisiologia , Humanos , Músculo Quadríceps/fisiologia , Estresse Mecânico , Análise e Desempenho de Tarefas , Adulto Jovem
13.
Exp Neurol ; 339: 113612, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33453213

RESUMO

This paper is an interdisciplinary narrative review of efficacious non-invasive therapies that are increasingly used to restore function in people with chronic spinal cord injuries (SCI). First presented are the secondary injury cascade set in motion by the primary lesion and highlights in therapeutic development for mitigating the acute pathophysiologic process. Then summarized are current pharmacological strategies for modulation of noradrenergic, serotonergic, and dopaminergic neurotransmission to enhance recovery in bench and clinical studies of subacute and chronic SCI. Last examined is how neuromechanical devices (i.e., electrical stimulation, robotic assistance, brain-computer interface, and augmented sensory feedback) could be comprehensively engineered to engage efferent and afferent motosensory pathways to induce neuroplasticity-based neural pattern generation. Emerging evidence shows that computational models of the human neuromusculoskeletal system (i.e., human digital twins) can serve as functionalized anchors to integrate different neuromechanical and pharmacological interventions into a single multimodal prothesis. The system, if appropriately built, may cybernetically optimize treatment outcomes via coordination of heterogeneous biosensory, system output, and control signals. Overall, these rehabilitation protocols involved neuromodulation to evoke beneficial adaptive changes within spared supraspinal, intracord, and peripheral neuromuscular circuits to elicit neurological improvement. Therefore, qualitatively advancing the theoretical understanding of spinal cord neurobiology and neuromechanics is pivotal to designing new ways to reinstate locomotion after SCI. Future research efforts should concentrate on personalizing combination therapies consisting of pharmacological adjuncts, targeted neurobiological and neuromuscular repairs, and brain-computer interfaces, which follow multimodal neuromechanical principles.


Assuntos
Interfaces Cérebro-Computador , Terapia por Estimulação Elétrica , Próteses Neurais , Plasticidade Neuronal/fisiologia , Recuperação de Função Fisiológica/fisiologia , Traumatismos da Medula Espinal/terapia , Agonistas Adrenérgicos/administração & dosagem , Animais , Interfaces Cérebro-Computador/tendências , Terapia Combinada/métodos , Terapia Combinada/tendências , Terapia por Estimulação Elétrica/métodos , Terapia por Estimulação Elétrica/tendências , Humanos , Próteses Neurais/tendências , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/fisiopatologia
14.
IEEE Trans Biomed Eng ; 68(1): 289-297, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32746046

RESUMO

OBJECTIVE: Monitoring athlete internal workload exposure, including prevention of catastrophic non-contact knee injuries, relies on the existence of a custom early-warning detection system. This system must be able to estimate accurate, reliable, and valid musculoskeletal joint loads, for sporting maneuvers in near real-time and during match play. However, current methods are constrained to laboratory instrumentation, are labor and cost intensive, and require highly trained specialist knowledge, thereby limiting their ecological validity and wider deployment. An informative next step towards this goal would be a new method to obtain ground kinetics in the field. METHODS: Here we show that kinematic data obtained from wearable sensor accelerometers, in lieu of embedded force platforms, can leverage recent supervised learning techniques to predict near real-time multidimensional ground reaction forces and moments (GRF/M). Competing convolutional neural network (CNN) deep learning models were trained using laboratory-derived stance phase GRF/M data and simulated sensor accelerations for running and sidestepping maneuvers derived from nearly half a million legacy motion trials. Then, predictions were made from each model driven by five sensor accelerations recorded during independent inter-laboratory data capture sessions. RESULTS: The proposed deep learning workbench achieved correlations to ground truth, by maximum discrete GRF component, of vertical Fz 0.97, anterior Fy 0.96 (both running), and lateral Fx 0.87 (sidestepping), with the strongest mean recorded across GRF components 0.89, and for GRM 0.65 (both sidestepping). CONCLUSION: These best-case correlations indicate the plausibility of the approach although the range of results was disappointing. The goal to accurately estimate near real-time on-field GRF/M will be improved by the lessons learned in this study. SIGNIFICANCE: Coaching, medical, and allied health staff could ultimately use this technology to monitor a range of joint loading indicators during game play, with the aim to minimize the occurrence of non-contact injuries in elite and community-level sports.


Assuntos
Aprendizado Profundo , Corrida , Dispositivos Eletrônicos Vestíveis , Aceleração , Fenômenos Biomecânicos , Humanos
15.
Gait Posture ; 83: 26-34, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33069126

RESUMO

BACKGROUND: Studies of walking in those with femoroacetabular impingement syndrome have found altered pelvis and hip biomechanics. But a whole body, time-contiuous, assessment of biomechanical parameters has not been reported. Additionally, larger cam morphology has been associated with more pain, faster progression to end-stage osteoarthritis and increased cartilage damage but differences in walking biomechanics between large compared to small cam morphologies have not been assessed. RESEARCH QUESTION: Are trunk, pelvis and lower limb biomechanics different between healthy pain-free controls and individuals with FAI syndrome and are those biomechanics different between those with larger, compared to smaller, cam morphologies? METHODS: Twenty four pain-free controls were compared against 41 participants with FAI syndrome who were stratified into two groups according to their maximum alpha angle. Participants underwent three-dimensional motion capture during walking. Trunk, pelvis, and lower limb biomechanics were compared between groups using statistical parametric mapping corrected for walking speed and pain. RESULTS: Compared to pain-free controls, participants with FAI syndrome walked with more trunk anterior tilt (mean difference 7.6°, p < 0.001) as well as less pelvic rise (3°, p < 0.001), hip abduction (-4.6°, p < 0.05) and external rotation (-6.5°, p < 0.05). They also had lower hip flexion (-0.06Nm⋅kg-1, p < 0.05), abduction (-0.07Nm⋅kg-1, p < 0.05) and ankle plantarflexion moments (-0.19Nm⋅kg-1, p < 0.001). These biomechanical differences occurred throughout the gait cycle. There were no differences in walking biomechanics according to cam morphology size. SIGNIFICANCE: Results do not support the hypothesis that larger cam morphology is associated with larger differences in walking biomechanics but did demonstrate general differences in trunk, pelvis and lower limb biomechanics between those with FAI sydrome and pain-free controls. Altered external biomechanics are likely the result of complex sensory-motor strategy resulting from pain inhibition or impingement avoidance. Future studies should examine internal loading in those with FAI sydnrome.


Assuntos
Fenômenos Biomecânicos/fisiologia , Impacto Femoroacetabular/complicações , Extremidade Inferior/fisiopatologia , Pelve/fisiopatologia , Tronco/fisiopatologia , Adolescente , Adulto , Feminino , Impacto Femoroacetabular/fisiopatologia , Articulação do Quadril , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Síndrome , Caminhada/fisiologia , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-32903393

RESUMO

Musculoskeletal tissues, including tendons, are sensitive to their mechanical environment, with both excessive and insufficient loading resulting in reduced tissue strength. Tendons appear to be particularly sensitive to mechanical strain magnitude, and there appears to be an optimal range of tendon strain that results in the greatest positive tendon adaptation. At present, there are no tools that allow localized tendon strain to be measured or estimated in training or a clinical environment. In this paper, we first review the current literature regarding Achilles tendon adaptation, providing an overview of the individual technologies that so far have been used in isolation to understand in vivo Achilles tendon mechanics, including 3D tendon imaging, motion capture, personalized neuromusculoskeletal rigid body models, and finite element models. We then describe how these technologies can be integrated in a novel framework to provide real-time feedback of localized Achilles tendon strain during dynamic motor tasks. In a proof of concept application, Achilles tendon localized strains were calculated in real-time for a single subject during walking, single leg hopping, and eccentric heel drop. Data was processed at 250 Hz and streamed on a smartphone for visualization. Achilles tendon peak localized strains ranged from ∼3 to ∼11% for walking, ∼5 to ∼15% during single leg hop, and ∼2 to ∼9% during single eccentric leg heel drop, overall showing large strain variation within the tendon. Our integrated framework connects, across size scales, knowledge from isolated tendons and whole-body biomechanics, and offers a new approach to Achilles tendon rehabilitation and training. A key feature is personalization of model components, such as tendon geometry, material properties, muscle geometry, muscle-tendon paths, moment arms, muscle activation, and movement patterns, all of which have the potential to affect tendon strain estimates. Model personalization is important because tendon strain can differ substantially between individuals performing the same exercise due to inter-individual differences in these model components.

17.
Front Physiol ; 11: 965, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32973544

RESUMO

Tendon geometry and tissue properties are important determinants of tendon function and injury risk and are altered in response to ageing, disease, and physical activity levels. The purpose of this study was to compare free Achilles tendon geometry and mechanical properties between trained elite/sub-elite middle-distance runners and a healthy control group. Magnetic resonance imaging (MRI) was used to measure free Achilles tendon volume, length, average cross-sectional area (CSA), regional CSA, moment arm, and T2* relaxation time at rest, while freehand three-dimensional ultrasound (3DUS) was used to quantify free Achilles tendon mechanical stiffness, Young's modulus, and length normalised mechanical stiffness. The free Achilles tendon in trained runners was significantly shorter and the average and regional CSA (distal end) were significantly larger compared to the control group. Mechanical stiffness of the free Achilles tendon was also significantly higher in trained runners compared to controls, which was explained by the group differences in tendon CSA and length. T2* relaxation time was significantly longer in trained middle-distance runners when compared to healthy controls. There was no relationship between T2* relaxation time and Young's modulus. The longer T2* relaxation time in trained runners may be indicative of accumulated damage, disorganised collagen, and increased water content in the free Achilles tendon. A short free Achilles tendon with large CSA and higher mechanical stiffness may enable trained runners to rapidly transfer high muscle forces and possibly reduce the risk of tendon damage from mechanical fatigue.

18.
Sci Rep ; 10(1): 8266, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32427881

RESUMO

Muscle synergies provide a simple description of a complex motor control mechanism. Synergies are extracted from muscle activation patterns using factorisation methods. Despite the availability of several factorisation methods in the literature, the most appropriate method for muscle synergy extraction is currently unknown. In this study, we compared four muscle synergy extraction methods: non-negative matrix factorisation, principal component analysis, independent component analysis, and factor analysis. Probability distribution of muscle activation patterns were compared with the probability distribution of synergy excitation primitives obtained from the four factorisation methods. Muscle synergies extracted using non-negative matrix factorisation best matched the probability distribution of muscle activation patterns across different walking and running speeds. Non-negative matrix factorisation also best tracked changes in muscle activation patterns compared to the other factorisation methods. Our results suggest that non-negative matrix factorisation is the best factorisation method for identifying muscle synergies in dynamic tasks with different levels of muscle contraction.


Assuntos
Músculo Esquelético/fisiologia , Corrida , Caminhada , Adulto , Análise Fatorial , Humanos , Masculino , Contração Muscular , Adulto Jovem
19.
Aust J Gen Pract ; 49(5): 272-275, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32416658

RESUMO

BACKGROUND: Osteoarthritis (OA) is one of the most common and debilitating chronic joint conditions in Australia. A National Osteoarthritis Strategy (the Strategy) was developed to outline a national plan to achieve optimal health outcomes for people at risk of, or with, OA. OBJECTIVE: This article focuses on the theme of prevention of OA within the Strategy. DISCUSSION: The Strategy was developed by a leadership group, three working groups, an implementation planning committee, multisectoral stakeholders and public consultation. The Strategy's 'Prevention Working Group' identified two priorities for action: 1) implement programs that target the prevention of obesity and increase physical activity, 2) adhere to joint injury prevention programs. The lack of implementable policies that promote OA prevention exposes Australians and the public health system to an enormous burden. A set of evidence-based strategies was proposed to assist implementation throughout Australia.


Assuntos
Osteoartrite/prevenção & controle , Planejamento Estratégico , Austrália/epidemiologia , Humanos , Obesidade/complicações , Osteoartrite/epidemiologia
20.
Bioorg Med Chem ; 28(5): 115261, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31987694

RESUMO

4-Aryl-4H-Chromene derivatives have been previously shown to exhibit anti-proliferative, apoptotic and anti-angiogenic activity in a variety of tumor models in vitro and in vivo generally via activation of caspases through inhibition of tubulin polymerisation. We have previously identified by Virtual Screening (VS) a 4-aryl-4H-chromene scaffold, of which two examples were shown to bind Estrogen Receptor α and ß with low nanomolar affinity and <20-fold selectivity for α over ß and low micromolar anti-proliferative activity in the MCF-7 cell line. Thus, using the 4-aryl-4H-chromene scaffold as a starting point, a series of compounds with a range of basic arylethers at C-4 and modifications at the C3-ester substituent of the benzopyran ring were synthesised, producing some potent ER antagonists in the MCF-7 cell line which were highly selective for ERα (compound 35; 350-fold selectivity) or ERß (compound 42; 170-fold selectivity).


Assuntos
Antineoplásicos/farmacologia , Benzopiranos/farmacologia , Receptores de Estrogênio/antagonistas & inibidores , Antineoplásicos/química , Benzopiranos/química , Proliferação de Células/efeitos dos fármacos , Cristalografia por Raios X , Avaliação Pré-Clínica de Medicamentos , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Células MCF-7 , Modelos Moleculares , Estrutura Molecular
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