A complete biomechanical model of Hydra contractile behaviors, from neural drive to muscle to movement.

How does neural activity drive muscles to produce behavior? The recent development of genetic lines in Hydra that allow complete calcium imaging of both neuronal and muscle activity, as well as systematic machine learning quantification of behaviors, makes this small cnidarian an ideal model system to understand and model the complete transformation from neural firing to body movements. To achieve this, we have built a neuromechanical model of Hydra's fluid-filled hydrostatic skeleton, showing how drive by neuronal activity activates distinct patterns of muscle activity and body column biomechanics. Our model is based on experimental measurements of neuronal and muscle activity and assumes gap junctional coupling among muscle cells and calcium-dependent force generation by muscles. With these assumptions, we can robustly reproduce a basic set of Hydra's behaviors. We can further explain puzzling experimental observations, including the dual timescale kinetics observed in muscle activation and the engagement of ectodermal and endodermal muscles in different behaviors. This work delineates the spatiotemporal control space of Hydra movement and can serve as a template for future efforts to systematically decipher the transformations in the neural basis of behavior.

Study on Static Biomechanical Model of Whole Body Based on Virtual Human.

Material handling tasks often lead to skeletal injury of workers. The whole-body static biomechanical modeling method based on virtual humans is the theoretical basis for analyzing the human factor index in the lifting process. This paper focuses on the study of humans' body static biomechanical model for virtual human ergonomics analysis: First, the whole-body static biomechanical model is constructed, which calculates the biomechanical data such as force and moment, average strength, and maximum hand load at human joints. Secondly, the prototype model test system is developed, and the real experiment environment is set up with the inertial motion capture system. Finally, the model reliability verification experiment and application simulation experiment are designed. The comparison results with the industrial ergonomic software show that the model is consistent with the output of the industrial ergonomic software, which proves the reliability of the model. The simulation results show that under the same load, the maximum joint load and the maximum hand load are strongly related to the working posture, and the working posture should be adjusted to adapt to the load. Upright or bent legs have less influence on the maximum load capacity of the hand. Lower hand load capacity is due to forearm extension, and the upper arm extension greatly reduces the load capacity of the hand. Compared with a one-handed load, the two-handed load has a greater load capacity.

Development and evaluation of a novel self-contained breathing apparatus pack to reduce musculoskeletal loads and enhance firefighter comfort.

Self­Contained Breathing Apparatus (SCBA) is an essential piece of personal protective equipment for firefighters, providing essential respiratory support and protection. A major challenge in SCBA research is to reduce musculoskeletal disorders and enhance firefighter comfort while carrying the SCBA. In this study, a novel SCBA pack was designed to reduce SCBA­related musculoskeletal stress. Ten volunteer firefighters were recruited to participate in the test protocol equipped with a novel SCBA (SCBANovel) and a traditional SCBA (SCBATrad) pack. Surface electromyography and pressure data were collected, and subjective ratings of discomfort using a visual analog scale. The results showed that the SCBANovel significantly reduced trapezius and erector spinae muscle activity. Shoulder and waist pressure were reduced by 19.73%­32.83% and 18.46%­41.55%, respectively. In addition, the SCBANovel pack reduced lower back discomfort scores by 59.1%, all compared to the SCBATrad pack. The SCBANovel pack showed a significant reduction in musculoskeletal stress and discomfort in firefighters.Practitioner SummarySCBAs are known to be critical in protecting the health of firefighters, but are often associated with firefighter discomfort and musculoskeletal disorders. We developed the SCBANovel pack and explored the effects on the upper body musculoskeletal system and comfort during walking and running compared to carrying the SCBATrad pack. The SCBANovel pack reduced muscle activity in the trapezius and erector spinae muscles and significantly reduced pressure on the shoulders and lower back.

Validation of Estimators for Weight-Bearing and Shoulder Joint Loads Using Instrumented Crutches.

This research paper aimed to validate two methods for measuring loads during walking with instrumented crutches: one method to estimate partial weight-bearing on the lower limbs and another to estimate shoulder joint reactions. Currently, gait laboratories, instrumented with high-end measurement systems, are used to extract kinematic and kinetic data, but such facilities are expensive and not accessible to all patients. The proposed method uses instrumented crutches to measure ground reaction forces and does not require any motion capture devices or force platforms. The load on the lower limbs is estimated by subtracting the forces measured by the crutches from the subject's total weight. Since the model does not consider inertia contribution in dynamic conditions, the estimation improves with low walking cadence when walking with the two-point contralateral and the three-point partial weight-bearing patterns considered for the validation tests. The shoulder joint reactions are estimated using linear regression, providing accurate values for the forces but less accurate torque estimates. The crutches data are acquired and processed in real-time, allowing for immediate feedback, and the system can be used outdoors in real-world walking conditions. The validation of this method could lead to better monitoring of partial weight-bearing and shoulder joint reactions, which could improve patient outcomes and reduce complications.

Validity of Inertial Measurement Units to Measure Lower-Limb Kinematics and Pelvic Orientation at Submaximal and Maximal Effort Running Speeds.

Inertial measurement units (IMUs) have been validated for measuring sagittal plane lower-limb kinematics during moderate-speed running, but their accuracy at maximal speeds remains less understood. This study aimed to assess IMU measurement accuracy during high-speed running and maximal effort sprinting on a curved non-motorized treadmill using discrete (Bland-Altman analysis) and continuous (root mean square error [RMSE], normalised RMSE, Pearson correlation, and statistical parametric mapping analysis [SPM]) metrics. The hip, knee, and ankle flexions and the pelvic orientation (tilt, obliquity, and rotation) were captured concurrently from both IMU and optical motion capture systems, as 20 participants ran steadily at 70%, 80%, 90%, and 100% of their maximal effort sprinting speed (5.36 ± 0.55, 6.02 ± 0.60, 6.66 ± 0.71, and 7.09 ± 0.73 m/s, respectively). Bland-Altman analysis indicated a systematic bias within ±1° for the peak pelvic tilt, rotation, and lower-limb kinematics and -3.3° to -4.1° for the pelvic obliquity. The SPM analysis demonstrated a good agreement in the hip and knee flexion angles for most phases of the stride cycle, albeit with significant differences noted around the ipsilateral toe-off. The RMSE ranged from 4.3° (pelvic obliquity at 70% speed) to 7.8° (hip flexion at 100% speed). Correlation coefficients ranged from 0.44 (pelvic tilt at 90%) to 0.99 (hip and knee flexions at all speeds). Running speed minimally but significantly affected the RMSE for the hip and ankle flexions. The present IMU system is effective for measuring lower-limb kinematics during sprinting, but the pelvic orientation estimation was less accurate.

Between Two Rocks and in a Hard Place: Reflecting on the Biomechanical Basis of Shoulder Occupational Musculoskeletal Disorders.

OBJECTIVE: The aim was to review the biomechanical origins of occupational shoulder damage, while considering the complexity of shoulder mechanics and musculoskeletal consequences of diverse task demands. BACKGROUND: Accessible measures of physical exposures are the primary focus of occupational shoulder assessments and analyses. This approach has led to guidelines and intervention strategies that are often inadequate for mitigating shoulder disorders amongst the complexity of modern workplace demands. Integration of complex shoulder mechanics into occupational assessments, analyses, and interventions is critical for reducing occupational shoulder injury risk. METHOD: This narrative review describes shoulder biomechanics in the context of common injury mechanisms and consequent injuries, with a particular focus on subacromial impingement syndrome. Several modulators of shoulder injury risk are reviewed, including fatigue, overhead work, office ergonomics considerations, and pushing and pulling task configurations. RESULTS: Relationships between work requirements, muscular demands, fatigue, and biomechanical tissue loads exist. This review highlights that consideration of specific workplace factors should be integrated with our knowledge of the intricate arrangement and interpersonal variability of the shoulder complex to proactively evaluate occupational shoulder demands and exposures. CONCLUSION: A standard method for evaluating shoulder muscle exposures during workplace tasks does not exist. An integrated approach is critical for improved work design and prevention of shoulder tissue damage and accompanying disability. APPLICATION: This review is particularly relevant for researchers and practitioners, providing guidance for work design and evaluation for shoulder injury prevention by understanding the importance of the unique and complex mechanics of the shoulder.

Left ventricular myocardial motion tracking in cardiac cine magnetic resonance images based on a biomechanical model.

BACKGROUND: Cardiac cine magnetic resonance (CCMR) imaging plays an important role in the clinical cardiovascular disease (CVD) examination and evaluation. OBJECTIVE: To accurately reconstruct the displacement field and describe the motion of the left ventricular myocardium (LVM), this study proposes and tests a new approach for tracking myocardial motion of the left ventricle based on a biomechanical model. METHODS: CCMR imaging data acquired from 103 patients are enrolled, including two simulated and 101 clinical data. A non-rigid image registration method with a combination of a thin-plate spline function and random sample consensus is used to recover the observed displacement field of LVM. Next, a biomechanical model and a material matrix are introduced to solve the dense displacement field of LVM using a finite element framework. Then, the tracking precision and error of results for the two groups are analyzed. RESULTS: Displacement results of the simulated data show correlation coefficient≥0.876 and mean square error≤0.159, while displacement results of the clinical data show Dice≥0.97 and mean contour distance≤0.464. Additionally, the strain results show correlation coefficient≥0.717. CONCLUSIONS: This study demonstrates that the proposed new method enables to accurately track the motion of the LVM and evaluate strain, which has clinical auxiliary value in the diagnosis of CVD.

Cell chirality regulates coherent angular motion on small circular substrates.

Collective cell migration occurs in a wide range of physiological and pathological processes, such as wound healing and tumor metastasis. Experiments showed that many types of cells confined in circular islands can perform coherent angular rotation, yet the underlying mechanisms remain unclear. Here we propose a biomechanical model, including the membrane, microtubules, and nucleus, to study the spatiotemporal evolutions of small cell clusters in confined space. We show that cells can spontaneously transfer from "radial pattern" to "chiral pattern" due to fluctuations. For a pair of cells with identical chiral orientation, the cluster rotates in the opposite direction of the chiral orientation, and the fluctuations can reverse the cluster's rotational direction. Interestingly, during the persistent rotation, each cell rotates around its own centroid while it is revolving around the island center and shows a constant side to the island center, as tidal locking in astronomy. Furthermore, for a few more cells, coherent angular rotation also appears, and the emergence of a central cell can accelerate the cluster rotation. These findings shed light on collective cell migration in life processes and help to understand the spatiotemporal dynamics of active matter.

OpenSense: An open-source toolbox for inertial-measurement-unit-based measurement of lower extremity kinematics over long durations.

BACKGROUND: The ability to measure joint kinematics in natural environments over long durations using inertial measurement units (IMUs) could enable at-home monitoring and personalized treatment of neurological and musculoskeletal disorders. However, drift, or the accumulation of error over time, inhibits the accurate measurement of movement over long durations. We sought to develop an open-source workflow to estimate lower extremity joint kinematics from IMU data that was accurate and capable of assessing and mitigating drift. METHODS: We computed IMU-based estimates of kinematics using sensor fusion and an inverse kinematics approach with a constrained biomechanical model. We measured kinematics for 11 subjects as they performed two 10-min trials: walking and a repeated sequence of varied lower-extremity movements. To validate the approach, we compared the joint angles computed with IMU orientations to the joint angles computed from optical motion capture using root mean square (RMS) difference and Pearson correlations, and estimated drift using a linear regression on each subject's RMS differences over time. RESULTS: IMU-based kinematic estimates agreed with optical motion capture; median RMS differences over all subjects and all minutes were between 3 and 6 degrees for all joint angles except hip rotation and correlation coefficients were moderate to strong (r = 0.60-0.87). We observed minimal drift in the RMS differences over 10 min; the average slopes of the linear fits to these data were near zero (- 0.14-0.17 deg/min). CONCLUSIONS: Our workflow produced joint kinematics consistent with those estimated by optical motion capture, and could mitigate kinematic drift even in the trials of continuous walking without rest, which may obviate the need for explicit sensor recalibration (e.g. sitting or standing still for a few seconds or zero-velocity updates) used in current drift-mitigation approaches when studying similar activities. This could enable long-duration measurements, bringing the field one step closer to estimating kinematics in natural environments.

Inertial Sensor-to-Segment Calibration for Accurate 3D Joint Angle Calculation for Use in OpenSim.

Inertial capture (InCap) systems combined with musculoskeletal (MSK) models are an attractive option for monitoring 3D joint kinematics in an ecological context. However, the primary limiting factor is the sensor-to-segment calibration, which is crucial to estimate the body segment orientations. Walking, running, and stair ascent and descent trials were measured in eleven healthy subjects with the Xsens InCap system and the Vicon 3D motion capture (MoCap) system at a self-selected speed. A novel integrated method that combines previous sensor-to-segment calibration approaches was developed for use in a MSK model with three degree of freedom (DOF) hip and knee joints. The following were compared: RMSE, range of motion (ROM), peaks, and R2 between InCap kinematics estimated with different calibration methods and gold standard MoCap kinematics. The integrated method reduced the RSME for both the hip and the knee joints below 5°, and no statistically significant differences were found between MoCap and InCap kinematics. This was consistent across all the different analyzed movements. The developed method was integrated on an MSK model workflow, and it increased the sensor-to-segment calibration accuracy for an accurate estimate of 3D joint kinematics compared to MoCap, guaranteeing a clinical easy-to-use approach.

Myoelectric Control Systems for Upper Limb Wearable Robotic Exoskeletons and Exosuits-A Systematic Review.

In recent years, myoelectric control systems have emerged for upper limb wearable robotic exoskeletons to provide movement assistance and/or to restore motor functions in people with motor disabilities and to augment human performance in able-bodied individuals. In myoelectric control, electromyographic (EMG) signals from muscles are utilized to implement control strategies in exoskeletons and exosuits, improving adaptability and human-robot interactions during various motion tasks. This paper reviews the state-of-the-art myoelectric control systems designed for upper-limb wearable robotic exoskeletons and exosuits, and highlights the key focus areas for future research directions. Here, different modalities of existing myoelectric control systems were described in detail, and their advantages and disadvantages were summarized. Furthermore, key design aspects (i.e., supported degrees of freedom, portability, and intended application scenario) and the type of experiments conducted to validate the efficacy of the proposed myoelectric controllers were also discussed. Finally, the challenges and limitations of current myoelectric control systems were analyzed, and future research directions were suggested.

The Influence of Cell Phone Usage on Dynamic Stability of the Body During Walking.

Dual-task walking and cell phone usage, which is associated with high cognitive load and reduced situational awareness, can increase risk of a collision, a fall event, or death. The objective of this study was to quantify the effect of dual-task cell phone talking, texting, and reading while walking on spatiotemporal gait parameters; minimum foot clearance; and dynamic stability of the lower limb joints, trunk, and head. Nineteen healthy male participants walked on an instrumented treadmill at their self-selected speed as well as walking while simultaneously (1) reading on a cell phone, (2) texting, and (3) talking on a cell phone. Gait analyses were performed using an optical motion analysis system, and dynamic stability was calculated using the Maximum Lyapunov Exponent. Dual-task cell phone usage had a significant destabilizing influence on the lower limb joints during walking. Cell phone talking while walking significantly increased step width and length and decreased minimum foot clearance height (P < .05). The findings suggest that dual-task walking and cell phone conversation may present a greater risk of a fall event than texting or reading. This may be due to the requirements for more rapid information processing and cognitive demand at the expense of motor control of joint stability.

The biomechanical efficacy of a hydrogel-based dressing in preventing facial medical device-related pressure ulcers.

Continuous positive airway pressure masks for breathing assistance are used widely during the coronavirus pandemic. Nonetheless, these masks endanger the viability of facial tissues even after a few hours because of the sustained tissue deformations and extreme microclimate conditions. The risk of developing such device-related pressure ulcers/injuries can be reduced through suitable cushioning materials at the mask-skin interface, to alleviate localised contact forces. Here, we determined the facial tissue loading state under an oral-nasal mask while using hydrogel-based dressing cuts (Paul Hartmann AG, Heidenheim, Germany) for prophylaxis, which is a new concept in prevention of device-related injuries. For this purpose, we measured the compressive mask-skin contact forces at the nasal bridge, cheeks, and chin with vs without these dressing cuts and fed these data to a finite element, adult head model. Model variants were developed to compare strain energy densities and effective stresses in skin and through the facial tissue depth, with vs without the dressing cuts. We found that the dry (new) dressing cuts reduced tissue exposures to loads (above the median loading level) by at least 30% at the nasal bridge and by up to 99% at the cheeks, across the tissue depth. These dressing cuts were further able to maintain at least 65% and 89% of their protective capacity under moisture at the nasal bridge and cheeks, respectively. The hydrogel-based dressings demonstrated protective efficacy at all the tested facial sites but performed the best at the nasal bridge and cheeks, which are at the greatest injury risk.

Nonlinear postural control paradigm for larger perturbations in the presence of neural delays.

Maintaining balance is an essential skill regulated by the central nervous system (CNS) that helps humans to function effectively. Developing a physiologically motivated computational model of a neural controller with good performance is a central component for a large range of potential applications, such as the development of therapeutic and assistive devices, diagnosis of balance disorders, and designing robotic control systems. In this paper, we characterize the biomechanics of postural control system by considering the musculoskeletal dynamics in the sagittal plane, proprioceptive feedback, and a neural controller. The model includes several physiological structures, such as the feedforward and feedback mechanism, sensory noise, and proprioceptive feedback delays. A high-gain observer (HGO)-based feedback linearization controller represents the CNS analog in the modeling paradigm. The HGO gives an estimation of delayed states and the feedback linearization control law generates the feedback torques at joints to execute postural recovery movements. The whole scheme is simulated in MATLAB/Simulink. The simulation results show that our proposed scheme is robust against larger perturbations, sensory noises, feedback delays and retains a strong disturbance rejection and trajectory tracking capability. Overall, these results demonstrate that the nonlinear system dynamics, the feedforward and feedback mechanism, and physiological latencies play a key role in shaping the motor control process.

Importance of the epiphyseal ring in OLIF stand-alone surgery: a biomechanical study on cadaveric spines.

PURPOSES: To explore the function of endplate epiphyseal ring in OLIF stand-alone surgery using a biomechanical model to reduce the complications of endplate collapse and cage subsidence. METHODS: In total, 24 human cadaveric lumbar function units (L1-2 and L3-4 segments) were randomly assigned to two groups. The first group was implanted with long fusion cages which engaged with both inner and outer regions of epiphyseal ring (Complete Span-Epiphyseal Ring, CSER). Those engaged with only the inner half of epiphyseal ring were the second group (Half Span-Epiphyseal Ring, HSER). Each group was divided into two subgroups [higher cage-height (HH) and normal cage-height (NH)]. Specimens were fixed in testing cups and compressed at approximately 2.5 mm/s, until the first sign of structural failure. Trabecular structural damage was analyzed by Micro-CT, as well as the difference of bone volume fraction (BV/TV), trabecular thickness (Tb.Th) et al. in different regions. RESULTS: Endplate collapse was mainly evident in the inner region of epiphyseal ring, where trabecular injury of sub-endplate bone was most concentrated. Endplate collapse incidence was significantly higher in HSER than CSER specimens (P = 0.017). A structural failure occurred at a lower force in HSER (1.41 ± 0.34 KN) compared with CSER (2.44 ± 0.59 KN). HH subgroups failed at a lower average force than NH subgroups. Micro-CT results showed a more extensive trabecular fracture in HSER specimens compared to CSER specimens, especially in HH subgroup. CONCLUSIONS: Endplate collapse is more likely to occur with short half span cages than complete span cages, and taller cages compared with normal height cages. During OLIF surgery, we should choose cages matching intervertebral disc space height and place the cages spanning over the whole epiphyseal ring to improve support strength.

A Two Joint Neck Model to Identify Malposition of the Head Relative to the Thorax.

Neck pain is a frequent health complaint. Prolonged protracted malpositions of the head are associated with neck pain and headaches and could be prevented using biofeedback systems. A practical biofeedback system to detect malpositions should be realized with a simple measurement setup. To achieve this, a simple biomechanical model representing head orientation and translation relative to the thorax is introduced. To identify the parameters of this model, anthropometric data were acquired from eight healthy volunteers. In this work we determine (i) the accuracy of the proposed model when the neck length is known, (ii) the dependency of the neck length on the body height, and (iii) the impact of a wrong neck length on the models accuracy. The resulting model is able to describe the motion of the head with a maximum uncertainty of 5 mm only. To achieve this high accuracy the effective neck length must be known a priory. If however, this parameter is assumed to be a linear function of the palpable neck length, the measurement error increases. Still, the resulting accuracy can be sufficient to identify and monitor a protracted malposition of the head relative to the thorax.

Modeling of the neural mechanism underlying the terrestrial turning of the salamander.

In order to explore the neural mechanism underlying salamander terrestrial turning, an improved biomechanical model is proposed by modifying the forelimb structure of the existing biomechanical model. Based on the proposed improved biomechanical model, a new spinal locomotor network model is constructed which contains the interneuron networks and motoneuron pool. Control methods are also developed for the new model which increase its transient response speed, control the initial swing order of the forelimbs, and generate different walking turning gait and turning on the spot (turning without moving forward). The simulation results show that the biomechanical model controlled by the new spinal locomotor network model can generate different walking turning and turning on the spot, and can control posture and the initial swing order of the forelimbs. Moreover, the transient response speed of the proposed model is very rapid. This paper thus provides a useful tool for exploring the operational mechanism of the spinal circuitry of the salamander. In addition, the research results presented here may inspire the construction of artificial spinal control networks for bionic robots.

Safety considerations for forward falls.

OBJECTIVE: Forward falls are among the most frequent causes of upper extremity fractures. This study investigated the safety considerations to prevent wrist injuries during bimanual forward falls. METHODS: A biomechanical model was developed with two separated arms to facilitate investigation of asymmetrical contact and predict the impact force applied to each hand separately. To validate the developed model, a series of fall experiments were conducted in which one hand collided with a hard surface, while the other collided with a soft surface. RESULTS: The results show that the impact force applied to each hand is independent of the other. Using these results and our model, the safety aspects of human forward falls were analyzed with a view to preventing injuries. Specifically, we sought to determine the safe range of surface stiffness and damping to ensure that the occurrence of forward falls does not lead to trauma. CONCLUSION: The results of this study can be applied in the design of compliant flooring to ensure the safety of people in environments with potential fall hazards. From a robotics viewpoint, the results are applicable in the design of compliant flooring for shared workplaces, where robots collaborate with people and collisions between humans and robots may cause falls.

Hip abductor muscle volumes are smaller in individuals affected by patellofemoral joint osteoarthritis.

OBJECTIVE: The aims of this study were twofold: firstly, to compare hip abductor muscle volumes in individuals with patellofemoral joint (PFJ) osteoarthritis (PFJ OA) against those of healthy controls; and secondly, to determine whether hip muscle volumes and hip kinematics during walking are related in individuals with PFJ OA and healthy controls. METHODS: Fifty-one individuals with PFJ OA and thirteen asymptomatic, age-matched healthy controls ≥40 years were recruited. Volumes of the gluteus medius, gluteus minimus and tensor fasciae latae were obtained from magnetic resonance (MR) images. Video motion capture was used to measure three-dimensional hip joint kinematics during overground walking. RESULTS: Significantly smaller gluteus medius (P = 0.017), gluteus minimus (P = 0.001) and tensor fasciae latae (P = 0.027) muscle volumes were observed in PFJ OA participants compared to controls. Weak correlations were observed between smaller gluteus minimus volume and larger hip flexion angle at contralateral heel strike (CHS) (r = -0.279, P = 0.038) as well as between smaller gluteus minimus volume and increased hip adduction angle at CHS (r = -0.286, P = 0.046). CONCLUSION: Reduced hip abductor muscle volume is a feature of PFJ OA and is associated with increased hip flexion and adduction angles during the late stance phase of walking for PFJ OA participants and healthy controls.

Three-dimensional finite element analysis of the pelvic organ prolapse: A parametric biomechanical modeling.

AIMS: To evaluate the role of soft tissue and ligaments damage and level of pelvic muscles activation versus intra-abdominal pressure, on pelvic organ prolapse. METHODS: This was a computational modeling based on the finite element analysis. Three pelvic muscles, four pelvic ligaments, and three organs (urethra, vagina, and rectum) were simulated. The model was subjected to total 41 472 analysis cases including three intra-abdominal pressures, two damaging levels for the ligaments, three damaging levels for the muscles, and four intentional levels of activation for muscles. RESULTS: Increased intra-abdominal pressures caused significant statistical increase of the pelvic organ prolapse (P = 0.000) up to 10 mm downward. Ligaments' defect had no statistically-significant effect on prolapse of the organs (P = 0.981 for rectum, P = 0.423 for urethra, and P = 0.752 for vagina). Damage in the pelvic floor muscles and low intentional level of activation also deteriorated the prolapse (P = 0.000). CONCLUSION: Increase of the intra-abdominal pressure (IAP) as may be existed during pregnancy or physical activity increased the organ prolapse. Damages of the ligaments caused less effects on the prolapse. Loss of the passive properties of the muscles which is probable after delivery or aging moderately deteriorated the prolapse disorder. However, activation of the pelvic floor muscles prevented the prolapse. Different recruitments of the muscles, specifically the pubococcygeus (PCM), could compensate the possible defects in other tissues. Targeted pelvic floor muscle training (PFMT) could also be effective in older adults due to considerable role of the pelvic muscles' intentional activation.