Dynamic Spatial Tuning Patterns of Shoulder Muscles with Volunteers in a Driving Posture.

Computational human body models (HBMs) of drivers for pre-crash simulations need active shoulder muscle control, and volunteer data are lacking. The goal of this paper was to build shoulder muscle dynamic spatial tuning patterns, with a secondary focus to present shoulder kinematic evaluation data. 8M and 9F volunteers sat in a driver posture, with their torso restrained, and were exposed to upper arm dynamic perturbations in eight directions perpendicular to the humerus. A dropping 8-kg weight connected to the elbow through pulleys applied the loads; the exact timing and direction were unknown. Activity in 11 shoulder muscles was measured using surface electrodes, and upper arm kinematics were measured with three cameras. We found directionally specific muscle activity and presented dynamic spatial tuning patterns for each muscle separated by sex. The preferred directions, i.e. the vector mean of a spatial tuning pattern, were similar between males and females, with the largest difference of 31° in the pectoralis major muscle. Males and females had similar elbow displacements. The maxima of elbow displacements in the loading plane for males was 189 ± 36 mm during flexion loading, and for females, it was 196 ± 36 mm during adduction loading. The data presented here can be used to design shoulder muscle controllers for HBMs and evaluate the performance of shoulder models.

Neck Muscle and Head/Neck Kinematic Responses While Bracing Against the Steering Wheel During Front and Rear Impacts.

Drivers often react to an impending collision by bracing against the steering wheel. The goal of the present study was to quantify the effect of bracing on neck muscle activity and head/torso kinematics during low-speed front and rear impacts. Eleven seated subjects (3F, 8 M) experienced multiple sled impacts (Δv = 0.77 m/s; apeak = 19.9 m/s2, Δt = 65.5 ms) with their hands on the steering wheel in two conditions: relaxed and braced against the steering wheel. Electromyographic activity in eight neck muscles (sternohyoid, sternocleidomastoid, splenius capitis, semispinalis capitis, semispinalis cervicis, multifidus, levator scapulae, and trapezius) was recorded unilaterally with indwelling electrodes and normalized by maximum voluntary contraction (MVC) levels. Head and torso kinematics (linear acceleration, angular velocity, angular rotation, and retraction) were measured with sensors and motion tracking. Muscle and kinematic variables were compared between the relaxed and braced conditions using linear mixed models. We found that pre-impact bracing generated only small increases in the pre-impact muscle activity (< 5% MVC) when compared to the relaxed condition. Pre-impact bracing did not increase peak neck muscle responses during the impacts; instead it reduced peak trapezius and multifidus muscle activity by about half during front impacts. Bracing led to widespread changes in the peak amplitude and timing of the torso and head kinematics that were not consistent with a simple stiffening of the head/neck/torso system. Instead pre-impact bracing served to couple the torso more rigidly to the seat while not necessarily coupling the head more rigidly to the torso.

Electrical Vestibular Stimuli Evoke Robust Muscle Activity in Deep and Superficial Neck Muscles in Humans.

Neck muscle activity evoked by vestibular stimuli is a clinical measure for evaluating the function of the vestibular apparatus. Cervical vestibular-evoked myogenic potentials (cVEMP) are most commonly measured in the sternocleidomastoid muscle (and more recently the splenius capitis muscle) in response to air-conducted sound, bone-conducted vibration or electrical vestibular stimuli. It is currently unknown, however, whether and how other neck muscles respond to vestibular stimuli. Here we measured activity bilaterally in the sternocleidomastoid, splenius capitis, sternohyoid, semispinalis capitis, multifidus, rectus capitis posterior, and obliquus capitis inferior using indwelling electrodes in two subjects exposed to binaural bipolar electrical vestibular stimuli. All recorded neck muscles responded to the electrical vestibular stimuli (0-100 Hz) provided they were active. Furthermore, the evoked responses were inverted on either side of the neck, consistent with a coordinated contribution of all left-right muscle pairs acting as antagonists in response to the electrically-evoked vestibular error of head motion. Overall, our results suggest that, as previously observed in cat neck muscles, broad connections exist between the human vestibular system and neck motoneurons and highlight the need for future investigations to establish their neural connections.

Head postures during naturalistic driving.

OBJECTIVE: A rotated head posture at the time of a rear-end impact is associated with a higher risk of acute and chronic whiplash injury. The objective of this study was to quantify the amplitude and duration of rotated head postures observed in drivers during naturalistic driving. METHODS: Twenty volunteers (14 males: 36 ± 12 years, 6 females: 27 ± 5 years) drove a 2010 Subaru Impreza on public roads while their 3D head angular position relative to the car was recorded using inertial measurement units. An experimenter rode in the passenger seat (right side) and logged when subjects performed one of 6 head movements: Bilateral shoulder and side mirror checks, looking at the rearview mirror, and looking at the front seat passenger. Video of the subjects was used to confirm the logged head movements and identify movements that the experimenter missed. The duration and amplitude of all 6 head movements were tabulated and then compared between periods when the car was moving and when the car was stationary. RESULTS: During a 68 ± 5-min drive, subjects performed a median (range) of 15 (5-39) left shoulder checks, 82.5 (29-167) left mirror checks, 40.5 (10-168) rearview mirror checks, 27.5 (3-113) right mirror checks, 60 (0-185) passenger looks, and 12.5 (1-28) right shoulder checks. Peak yaw angles of the head relative to the vehicle for these 6 movements averaged -81.5°, -34.3°, 16.2°, 42.1°, 58.2°, and 84.3°, respectively. Drivers spent a larger proportion of time in nonneutral postures when the vehicle was stopped (17.5%) compared to moving (8.2%) (Z = 3.92, P < .0001). Drivers also moved their head further from neutral during the movements when the car was stationary compared to moving (t19 = 5.90, P < .0001). CONCLUSIONS: Drivers use larger and longer duration head movements when stationary than when driving. Given an increased risk of whiplash injury for initially rotated head postures, these findings provide a possible explanation for why drivers are more likely to be injured when hit from behind while their vehicle is stationary. Further, the head postures characterized in this study can be used as initial conditions in volunteer and computational studies to improve our understanding of why nonneutral head postures are associated with increased whiplash injury risk.

Neck muscle biomechanics and neural control.

The mechanics, morphometry, and geometry of our joints, segments, and muscles are fundamental biomechanical properties intrinsic to human neural control. The goal of our study was to investigate whether the biomechanical actions of individual neck muscles predict their neural control. Specifically, we compared the moment direction and variability produced by electrical stimulation of a neck muscle (biomechanics) to the preferred activation direction and variability (neural control). Subjects sat upright with their head fixed to a six-axis load cell and their torso restrained. Indwelling wire electrodes were placed into the sternocleidomastoid (SCM), splenius capitis (SPL), and semispinalis capitis (SSC) muscles. The electrically stimulated direction was defined as the moment direction produced when a current (2-19 mA) was passed through each muscle's electrodes. Preferred activation direction was defined as the vector sum of the spatial tuning curve built from root mean squared electromyogram when subjects produced isometric moments at 7.5% and 15% of their maximum voluntary contraction (MVC) in 26 three-dimensional directions. The spatial tuning curves at 15% MVC were well defined (unimodal, P < 0.05), and their preferred directions were 23°, 39°, and 21° different from their electrically stimulated directions for the SCM, SPL, and SSC, respectively ( P < 0.05). Intrasubject variability was smaller in electrically stimulated moment directions compared with voluntary preferred directions, and intrasubject variability decreased with increased activation levels. Our findings show that the neural control of neck muscles is not based solely on optimizing individual muscle biomechanics but, as activation increases, biomechanical constraints in part dictate the activation of synergistic neck muscles. NEW & NOTEWORTHY Biomechanics are an intrinsic part of human neural control. In this study, we found that the biomechanics of individual neck muscles cannot fully predict their neural control. Consequently, physiologically based computational neck muscle controllers cannot calculate muscle activation schemes based on the isolated biomechanics of muscles. Furthermore, by measuring biomechanics we showed that the intrasubject variability of the neural control was lower for electrical vs. voluntary activation of the neck muscles.

Trunk muscle recruitment patterns in simulated precrash events.

OBJECTIVES: To quantify trunk muscle activation levels during whole body accelerations that simulate precrash events in multiple directions and to identify recruitment patterns for the development of active human body models. METHODS: Four subjects (1 female, 3 males) were accelerated at 0.55 g (net Δv = 4.0 m/s) in 8 directions while seated on a sled-mounted car seat to simulate a precrash pulse. Electromyographic (EMG) activity in 4 trunk muscles was measured using wire electrodes inserted into the left rectus abdominis, internal oblique, iliocostalis, and multifidus muscles at the L2-L3 level. Muscle activity evoked by the perturbations was normalized by each muscle's isometric maximum voluntary contraction (MVC) activity. Spatial tuning curves were plotted at 150, 300, and 600 ms after acceleration onset. RESULTS: EMG activity remained below 40% MVC for the three time points for most directions. At the 150- and 300 ms time points, the highest EMG amplitudes were observed during perturbations to the left (-90°) and left rearward (-135°). EMG activity diminished by 600 ms for the anterior muscles, but not for the posterior muscles. CONCLUSIONS: These preliminary results suggest that trunk muscle activity may be directionally tuned at the acceleration level tested here. Although data from more subjects are needed, these preliminary data support the development of modeled trunk muscle recruitment strategies in active human body models that predict occupant responses in precrash scenarios.

Prediction of three dimensional maximum isometric neck strength.

We measured maximum isometric neck strength under combinations of flexion/extension, lateral bending and axial rotation to determine whether neck strength in three dimensions (3D) can be predicted from principal axes strength. This would allow biomechanical modelers to validate their neck models across many directions using only principal axis strength data. Maximum isometric neck moments were measured in 9 male volunteers (29±9 years) for 17 directions. The 3D moments were normalized by the principal axis moments, and compared to unity for all directions tested. Finally, each subject's maximum principal axis moments were used to predict their resultant moment in the off-axis directions. Maximum moments were 30±6 N m in flexion, 32±9 N m in lateral bending, 51±11 N m in extension, and 13±5 N m in axial rotation. The normalized 3D moments were not significantly different from unity (95% confidence interval contained one), except for three directions that combined ipsilateral axial rotation and lateral bending; in these directions the normalized moments exceeded one. Predicted resultant moments compared well to the actual measured values (r2=0.88). Despite exceeding unity, the normalized moments were consistent across subjects to allow prediction of maximum 3D neck strength using principal axes neck strength.

Investigation of whiplash injuries in the upper cervical spine using a detailed neck model.

Whiplash injuries continue to have significant societal cost; however, the mechanism and location of whiplash injury is still under investigation. Recently, the upper cervical spine ligaments, particularly the alar ligament, have been identified as a potential whiplash injury location. In this study, a detailed and validated explicit finite element model of a 50th percentile male cervical spine in a seated posture was used to investigate upper cervical spine response and the potential for whiplash injury resulting from vehicle crash scenarios. This model was previously validated at the segment and whole spine levels for both kinematics and soft tissue strains in frontal and rear impact scenarios. The model predicted increasing upper cervical spine ligament strain with increasing impact severity. Considering all upper cervical spine ligaments, the distractions in the apical and alar ligaments were the largest relative to their failure strains, in agreement with the clinical findings. The model predicted the potential for injury to the apical ligament for 15.2 g frontal or 11.7 g rear impacts, and to the alar ligament for a 20.7 g frontal or 14.4 g rear impact based on the ligament distractions. Future studies should consider the effect of initial occupant position on ligament distraction.

Cervical spine response in frontal crash.

Predicting neck response and injury resulting from motor vehicle accidents is essential to improving occupant protection. A detailed human cervical spine finite element model has been developed, with material properties and geometry determined a priori of any validation, for the evaluation of global kinematics and tissue-level response. Model validation was based on flexion/extension response at the segment level, tension response of the whole ligamentous cervical spine, head kinematic response from volunteer frontal impacts, and soft tissue response from cadaveric whole cervical spine frontal impacts. The validation responses were rated as 0.79, assessed using advanced cross-correlation analysis, indicating the model exhibits good biofidelity. The model was then used to evaluate soft tissue response in frontal impact scenarios ranging from 8G to 22G in severity. Disc strains were highest in the C4-C5-C6 segments, and ligament strains were greatest in the ISL and LF ligaments. Both ligament and disc fiber strain levels exceeded the failure tolerances in the 22G case, in agreement with existing data. This study demonstrated that a cervical spine model can be developed at the tissue level and provide accurate biofidelic kinematic and local tissue response, leading to injury prediction in automotive crash scenarios.

Cervical spine model to predict capsular ligament response in rear impact.

Predicting neck kinematics and tissue level response is essential to evaluate the potential for occupant injury in rear impact. A detailed 50th percentile male finite element model, previously validated for frontal impact, was validated for rear impact scenarios with material properties based on actual tissue properties from the literature. The model was validated for kinematic response using 4 g volunteer and 7 g cadaver rear impacts, and at the tissue level with 8 g isolated full spine rear impact data. The model was then used to predict capsular ligament (CL) strain for increasing rear impact severity, since CL strain has been implicated as a source of prolonged pain resulting from whiplash injury. The model predicted the onset of CL injury for a 14 g rear impact, in agreement with motor vehicle crash epidemiology. More extensive and severe injuries were predicted with increasing impact severity. The importance of muscle activation was demonstrated for a 7 g rear impact where the CL strain was reduced from 28 to 13% with active muscles. These aspects have not previously been demonstrated experimentally, since injurious load levels cannot be applied to live human subjects. This study bridges the gap between low intensity volunteer impacts and high intensity cadaver impacts, and predicts tissue level response to assess the potential for occupant injury.