Analysis of ebike dynamics and cyclists' anxiety levels and interactions with road vehicles that influence safety.

The significance of commuting with ebikes as an integral part of the urban mobility of the future can no longer be ignored. The real and perceived hazards of cycling in urban areas and sharing roads with other motorized vehicles have been identified as a major barrier to wider adoption of ebikes. The objective of this study is to investigate parameters that affect the anxiety level of cyclists, which influences their safety and interaction with other road users. An ebike was instrumented with a variety of sensors and equipment to monitor the speed, balance of bike, type, and proximity of vehicles overtaking cyclists, as well as the events on the road. Thirty-two participants rode the instrumented ebike for 12 km on urban roads in Oshawa, ON, Canada. Participants wore a heart rate sensor attached to their chest and a helmet equipped with a peripheral detection task setup to measure stress and mental workload. This naturalistic study showed that most participants had concerns about the threats and risks of crashes when sharing the road with other vehicles. The data showed that the significant difference in acceleration between ebikes and conventional bikes does not change the perception of safety for cyclists. Additionally, the outcomes indicate that mental workload and average heart rate increase at lower speeds when passing a queue of vehicles in traffic or at intersections. Across all participants, the balance of the bike did not change significantly. Also, neither the heart rate nor mental workload showed a significant effect on the balance of the bike. This study suggests that dense traffic in the afternoon and the demands of riding a bike in complex traffic conditions result in a higher mental workload even though cyclists slowed down their speeds. Furthermore, the majority reported perceived risks of cycling on a shared road with other vehicles regardless of the demographic differences. The findings from this study can be used as a framework for the development of active safety features for ebikes.

A comparison of knee joint moments during high flexion squatting and kneeling postures in healthy individuals.

BACKGROUND: Deep knee bending has been reported as an occupational hazard to workers who have to adopt such postures. High knee joint moments have been associated with knee osteoarthritis initiation and progression. OBJECTIVE: This study aimed to compare four high knee flexion postures (dorsiflexed and plantarflexed kneeling, and flat-foot and heels-up squatting) to determine which one results in lower knee joint flexion and ab/adduction moments. METHODS: Forty-three participants performed five trials of each posture. Peak (for descent/ascent) and mean (for the static hold) external knee flexion and ab/adduction moments were analyzed for each posture using 2-way ANOVAs and post-hoc pairwise comparisons. RESULTS: It was observed that the flat-foot squat resulted in significantly lower knee flexion moment compared to the other three postures (4.63±0.99 % BW·H during the static phase, and 5.83±1.24 % BW·H and 5.94±1.24 % BW·H during descent and ascent phases, respectively). During ascent phase, significant differences was indicated in peak adduction moments for the flat-foot squat in comparison to both styles of kneeling. CONCLUSIONS: When high knee flexion is required but posture is not dictated, flat-foot squat will reduce exposures to high knee moments.

Effects of Knee Savers on the quadriceps muscle activation across deep knee bending postures.

Workers who kneel or squat frequently are at a high risk of developing knee pathologies. Knee Savers® are wedge-shaped pads, worn on the lower calf by baseball catchers that aim to reduce this risk. This study examined how Knee Savers® change the bilateral quadriceps muscle activity during dorsiflexed kneeling, and heels-up and flat-foot squatting. For twenty participants, integrated and peak electromyography (EMG) during descent and ascent phases, mean EMG during a 10-s static phase, and participants' subjective perception of muscle fatigue were compared between equipment conditions (with (W) and without (WO) Knee Savers®). Knee Savers® did not significantly reduce integrated or peak EMG during transitions into and out of the postures; however, they significantly reduced (p < .03) mean EMG in five of six muscles during the static phase. These findings indicate potential for Knee Savers® to reduce cumulative muscular effort and fatigue in applications where prolonged static kneeling or squatting are required.

Customized surface-guided knee implant: Contact analysis and experimental test.

Contact pressure and stresses on the articulating surface of the tibial component of a total knee replacement are directly related to the joint contact forces and the contact area. These stresses can result in wear and fatigue damage of the ultra-high-molecular-weight polyethylene. Therefore, conducting stress analysis on a newly designed surface-guided knee implant is necessary to evaluate the design with respect to the polyethylene wear. Finite element modeling is used to analyze the design's performance in level walking, stair ascending and squatting. Two different constitutive material models have been used for the tibia component to evaluate the effect of material properties on the stress distribution. The contact pressure results of the finite element analysis are compared with the results of contact pressure using pressure-sensitive film tests. In both analyses, the average contact pressure remains below the material limits of ultra-high-molecular-weight polyethylene insert. The peak von Mises stresses in 90° of flexion and 120° of flexion (squatting) are 16.28 and 29.55 MPa, respectively. All the peak stresses are less than the fatigue failure limit of ultra-high-molecular-weight polyethylene which is 32 MPa. The average contact pressure during 90° and 120° of flexion in squatting are 5.51 and 5.46 MPa according to finite element analysis and 5.67 and 8.14 MPa according to pressure-sensitive film experiment. Surface-guided knee implants are aimed to resolve the limitations in activities of daily living after total knee replacement by providing close to normal kinematics. The proposed knee implant model provides patterns of motion much closer to the natural target, especially as the knee flexes to higher degrees during squatting.

The influence of geometric design variables on the kinematic performance of a surface-guided total knee replacement.

OBJECTIVE: Tibiofemoral geometries in a total knee replacement (TKR) affect the performance of an implant during activities of daily living. The specially shaped components of a surface-guided TKR aim to control the tibiofemoral motion, such that a normal pattern of motion is achieved, even at high flexion angles. The purpose of this study was to assess the influence of the design parameters on the kinematic behavior of such an implant. A combination of design variables was determined that resulted in the least deviation from the design kinematic target. METHODS: Six major design variables were considered to generate customized surface-guided TKR candidates. The contribution of these variables was evaluated by principal component analysis considering the input design variables and the results of the kinematic performance from a virtual simulation of deep squatting. The tibial internal-external rotation and the anterior-posterior translation of the medial and lateral femoral condyles were recorded for each design candidate. A quantified objective function of the kinematic behavior was used to define the design with a maximum agreement with the target pattern of motion. RESULTS: The location and orientation of the flexion-extension axis and the tibial slope were the most contributing parameters on the modes of variation. On the other hand, the conformity between the lateral guiding arcs had the least contribution. CONCLUSION: Virtual simulation showed that the current TKR reached deep flexion angles under squat load, while the tibia pivoted around the medial center. The tibial rotation was within the expected range of the IE rotation from healthy joints.

Kinematic behavior of a customized surface-guided knee implant during simulated knee-bending.

Different designs of total knee replacements (TKRs) aim to enhance the satisfaction of the patients by providing close to normal kinematics. In the surface-guided TKRs, the guidance of the motion in a normal pattern should be achieved through specially shaped articulating geometries. This study used virtual simulation along with a load-controlled knee wear simulator to evaluate the kinematic performance of a customized surface-guided TKR under weight-bearing conditions of lunging and squatting activities. The outcome pattern of TKR motion almost agreed with the predefined design target. The tibial insert rotated internally through a maximum angle of 10.6° and 19.94° for the experimentally simulated lunging and squatting cycles, respectively. This rotation occurred around a medial center, as indicated by a small amount of posterior translation of the medial condyle (maximum of 2.5mm and 6.4mm for lunging and squatting) versus the posterior translation of the lateral condyle (maximum of 12mm and 24.2mm for lunging and squatting). The contact forces mainly provided the guidance of the motion at the tibiofemoral articulating surfaces.The normalized root mean square error between outcomes of the virtual simulations and tests for the angle of internal-external rotation of the tibial insert was less than 8% for one cycle of lunging and squatting. These measures confirm the validity of the virtual simulation for future evaluations of the customized surface-guided TKRs.

Design and virtual evaluation of a customized surface-guided knee implant.

Although total knee arthroplasty is generally a successful operation, many studies have shown that it results in significant alterations in the kinematics of the joint, which cause limitations in performing the activities of daily living. This study aimed to define the design features for a customized surface-guided total knee replacement and to evaluate the kinematic outcomes. Magnetic resonance imaging data of the knee joint are used to generate the design features as they relate to the functionality of the implant. The motion is guided by considering a partial ball and socket configuration on the medial condyle and varying radii of curvature on the lateral articulating surface. A virtual simulation of the behavior of the surface-guided total knee replacement was performed to investigate the motion patterns of this total knee replacement under gait and squatting loading conditions. Results of the virtual simulation show that flexion and extension of the knee make the center of the lateral condyle move more naturally in the posterior and anterior directions, in comparison to the center of the medial condyle. Such guidance is achieved as a result of the novel customized designed contact between the articulating surfaces. The proposed customized surface-guided total knee replacement provides patterns of motion close to the expected more natural target, not only during a gait cycle but also as the knee flexes to higher degrees during squatting. Major design features include location and orientation of the flexion and pivoting axes, the trace of the contact points on the tibia, and the radii of the guiding arcs on the lateral condyle.

Design optimization of an above-knee prosthesis based on the kinematics of gait.

A dynamic model of an above-knee prosthesis during the complete gait cycle was developed. The model was based on a two-dimensional multi-body mechanical system and included a hydraulic and an elastic controller for the knee and a kinematical driver controller for the prosthetic ankle. The equations of motion were driven using Lagrange method. Simulation of the foot contact was conducted using a two-point penetration contact model. The knee elastic and hydraulic controller units, the knee extension stop, and the kinematical driver controller of the ankle were represented by a spring and a dashpot, a nonlinear spring, and a torsional spring-damper within a standard prosthetic configuration. The hip trajectory and net joint moment were considered as the initial conditions of the coupled differential equations. Design optimization of the prosthesis, to achieve the closest knee flexion pattern to that of the normal gait, resulted in a good correlation; the average differences with normal data were 3.3 and 3.4 deg for prosthetic knee and ankle joints, respectively. A parametric study showed that both increase and decrease of the stiffness by 50% caused an earlier knee flexion in stance phase and a lower knee flexion in swing phase. The effect of hydraulic controller damping coefficient on the flexion pattern of the prosthetic knee and ankle was only significant in the swing phase of the gait cycle.