Independent volumetric internal fixation reduces posterior column acetabular fracture site motion as compared to plate/screw construct: A biomechanical analysis.

Aims & objectives: To establish whether a suprapectineal pelvic reconstruction plate and posterior column screw (P&S) construct or a single 6.5-mm cannulated posterior column screw (PCS) construct demonstrates greater mechanical stability for fixation of acetabulum fractures involving the posterior column (PC). We hypothesized that the PCS construct would result in less fracture site motion. Materials & methods: Twelve fourth-generation composite hemipelvi were utilized, 6 for each construct. The P&S construct consisted of a suprapectineal pelvic reconstruction plate with two 3.5-mm posterior column screws crossing the fracture site in lag-by-technique fashion and two screws anchoring the plate to the sciatic buttress. The PCS construct consisted of a single 6.5-mm partially threaded cannulated screw placed in an antegrade fashion. Both fixation models were cyclically loaded at 0.5 cycles/second at 400N and 800N, first in a sit-to-stand position that is expected during recovery, and subsequently in a squat-to-stand position to test overload conditions. Results: Under sit-to-stand loading, the PCS construct resulted in less motion at the fracture site than the P&S construct (0.06 ± 0.02 mm vs 0.1 ± 0.02 mm at 400N, p = 0.02; 0.13 ± 0.03 mm vs 0.19 ± 0.04 mm at 800N, p = 0.03). The PCS construct also demonstrated less fracture site motion under squat-to-stand loading (0.22 ± 0.13 mm vs 1.9 ± 0.5 mm at 400N, p = < 0.001; 1.48 ± 0.44 mm vs 4.77 ± 0.3 mm at 800N, p = < 0.001). At 800 N, half of the repairs failed during squat-to-stand loading (2 PCS, 4 P&S). Conclusion: Fixation of the posterior column of the acetabulum with a 6.5-mm cannulated screw demonstrated comparable fracture motion upon loading compared to the plate and screw construct.

Countermovement jump and vertical hop demonstrate braking/deceleration and performance alterations after ACL reconstruction with BMA, DBM, and suture tape augmentation.

Objectives: This study evaluated countermovement jump and Single Leg Jump measures to identify landing measures that best distinguish a novel Anterior Cruciate Ligament reconstruction technique using bone marrow aspirate, demineralized bone matrix, and suture tape augmentation patients from controls. The secondary objective assessed performance differences between operated and non-operated limbs post-reconstruction. The hypothesis was that novel Anterior Cruciate Ligament reconstruction patients at return to sport would not differ from controls during landing and that the operated limb's performance would not differ from the unoperated limb. Methods: The study included 31 patients with the novel reconstruction technique matched with controls in a 1:10 ratio based on age, sex, weight, and height. Both groups underwent screening and were compared during a Countermovement Jump. Using a Sparta Science Force Platform, each patient's unoperated and operated limbs were also compared for Single Leg Jump post-op (6.5 months). Results: Test patients showed no difference in center of pressure during landing of both jumps compared to controls (P=0.27) and the uninvolved limb (P=0.26). Test patients exhibited increased braking impulse relative to the uninvolved limb during Single Leg Jump (P<0.001). Deceleration upon landing of Countermovement Jump was also increased compared to controls (P<0.001). Test patients demonstrated slower concentric time during a Countermovement Jump compared to controls (P=0.03) and significantly slower compared to the uninjured leg (P<0.001). Countermovement Jump height was decreased compared to controls (P<0.001). Single-leg jump height was decreased in the injured limb compared to the uninjured limb (P<0.001). Conclusions: Test patients did not show significant differences in landing motion compared to controls or the uninvolved leg. However, power and performance alterations were evident at Return to Sport after reconstruction. Although these results are quite promising, they may be too preliminary to draw definitive conclusions. Double and single-legged assessments should be considered in return-to-sport decision-making.

Mecánica y energética durante la marcha en cinta caminadora en adultos uruguayos saludables: efecto del IMC y la edad / Mechanics and energy during treadmill walking in healthy uruguayan adults: effect of BMI and age / Mecânica e energia durante a caminhada em esteira em adultos uruguaios saudáveis: efeito do IMC e Idade

La evaluación de la marcha en cinta caminadora puede resultar relevante para la toma de decisiones clínicas. No obstante, factores demográficos como la edad y el IMC pueden alterar la interpretación de los resultados. Nuestro objetivo fue obtener variables espacio- temporales, energéticas y costo de transporte durante la velocidad autoseleccionada en cinta caminadora para una muestra representativa de adultos uruguayos (n=28) y evaluar si diferentes rangos de edades e IMC pueden ser factores a tener en cuenta en pruebas clínicas donde se consideren dichas variables. Participaron 17 hombres y 11 mujeres (39,3 ± 14,8 años, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Se realizó una reconstrucción 3D del movimiento en forma sincronizada con el consumo energético. Se obtuvieron valores de referencia y luego de agrupar los participantes según su IMC y rango de edad se compararon los datos mediante test de t (p≤0.05). Los resultados revelaron discrepancias significativas en las medidas espacio-temporales y energéticas de los adultos uruguayos al caminar en cinta con respecto a la literatura. La marcha difiere entre adultos jóvenes y de mediana edad en su velocidad autoseleccionada (p=0,03), longitud de zancada (p=0,01), trabajo mecánico externo (<0,001) y recuperación de energía mecánica (0,009), destacando la importancia de considerar la edad en evaluaciones clínicas. El IMC no influyó significativamente en estas variables. Estos hallazgos subrayan la necesidad de ajustar las interpretaciones de las pruebas clínicas de la marcha sobre cinta caminadora en adultos uruguayos de mediana edad (45 a 65 años).

Treadmill gait assessment can be relevant for clinical decision-making. However, demographic factors such as age and BMI may alter result interpretation. Our aim was to obtain spatiotemporal, energetic, and cost of transport variables during self-selected treadmill walking speed for a representative sample of Uruguayan adults (n=28) and to assess if different age ranges and BMI could be factors to consider in clinical tests involving these variables. Seventeen men and eleven women participated (39.3 ± 14.8 years, 75.9 ± 12.5 kg, 1.74 ± 0.09 m, BMI 25.2 ± 4.06). A synchronized 3D motion reconstruction was performed with energy consumption. Reference values were obtained and data were compared using t-tests (p≤0.05), after grouping participants by BMI and age range. Results revealed significant discrepancies in spatiotemporal and energetic measures of Uruguayan adults walking on the treadmill, compared to the literature. Gait differed between young and middle-aged adults in their self-selected speed (p=0.03), stride length (p=0.01), external mechanical work (p<0.001), and mechanical energy recovery (0.009), emphasizing the importance of considering age in clinical evaluations. BMI did not significantly influence these variables. These findings underscore the need to adjust interpretations of treadmill gait clinical tests in middle-aged Uruguayan adults (45 to 65 years).

A avaliação da marcha na esteira pode ser relevante para a tomada de decisões clínicas. No entanto, fatores demográficos como idade e IMC podem alterar a interpretação dos resultados. Nosso objetivo foi obter variáveis espaço-temporais, energéticas e custo de transporte durante a velocidade de caminhada autoselecionada na esteira para uma amostra representativa de adultos uruguaios (n = 28) e avaliar se diferentes faixas etárias e IMC podem ser fatores a serem considerados em testes clínicos que envolvam essas variáveis. Dezessete homens e onze mulheres participaram (39,3 ± 14,8 anos, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Foi realizada uma reconstrução tridimensional do movimento sincronizada com o consumo de energia. Foram obtidos valores de referência e os dados foram comparados usando testes t (p≤0,05), após agrupar os participantes por IMC e faixa etária. Os resultados revelaram discrepâncias significativas nas medidas espaço-temporais e energéticas dos adultos uruguaios ao caminhar na esteira, em comparação com a literatura. A marcha diferiu entre adultos jovens e de meia-idade em sua velocidade autoselecionada (p=0,03), comprimento da passada (p=0,01), trabalho mecânico externo (<0,001) e recuperação de energia mecânica (0,009), destacando a importância de considerar a idade em avaliações clínicas. O IMC não influenciou significativamente essas variáveis. Esses achados destacam a necessidade de ajustar as interpretações dos testes clínicos de marcha na esteira em adultos uruguaios de meia- idade (45 a 65 anos).

Quantification of finger grasps during activities of daily life using convolutional neural networks: A pilot study.

Quantifying finger kinematics can improve the authors' understanding of finger function and facilitate the design of efficient prosthetic devices while also identifying movement disorders and assessing the impact of rehabilitation interventions. Here, the authors present a study that quantifies grasps depicted in taxonomies during selected Activities of Daily Living (ADL). A single participant held a series of standard objects using specific grasps which were used to train Convolutional Neural Networks (CNN) for each of the four fingers individually. The experiment also recorded hand manipulation of objects during ADL. Each set of ADL finger kinematic data was tested using the trained CNN, which identified and quantified the grasps required to accomplish each task. Certain grasps appeared more often depending on the finger studied, meaning that even though there are physiological interdependencies, fingers have a certain degree of autonomy in performing dexterity tasks. The identified and most frequent grasps agreed with the previously reported findings, but also highlighted that an individual might have specific dexterity needs which may vary with profession and age. The proposed method can be used to identify and quantify key grasps for finger/hand prostheses, to provide a more efficient solution that is practical in their day-to-day tasks.

Superior Measurement Accuracy of Digital Thickness Gauge Versus Digital Vernier Caliper in Determining Venous Tissue Thickness.

Background In determining mechanical characteristics, the accuracy of the thickness of the specimens can influence the biomechanical behavior, especially in the case of human tissues, where there is an important variability. This study aims to compare the accuracy of two routine measuring instruments, i.e., the digital vernier caliper and the digital thickness gauge, when measuring the thickness of venous specimens multiple times. Methodology In this study, we used 12 tubular vena cava specimens obtained from common breed pigs aged 18-24 weeks at the time of sacrifice from a local slaughterhouse. The measurements were performed using a digital vernier caliper (Multicomp PRO MP012475) for the first four protocols and a digital thickness gauge (Mitutoyo 547-500S) for the fifth protocol. In the first protocol, three measurements were taken on the same side, and their average was recorded as the sample thickness. The second protocol involved taking measurements on two opposite sides, and the average of these measurements was recorded as the sample thickness. In the third protocol, the thickness of each side was measured at its midpoint, and the average of the four measurements was recorded as the sample thickness. In the last protocol using a digital vernier caliper, the thickness of the vernier specimens was calculated as the average of the measurements taken at each corner of the square sample. Finally, for the fifth protocol, three consecutive measurements were taken using the digital thickness gauge, and their average was recorded as the final thickness of the sample. Results In the first protocol, we observed lower values during the first measurement in comparison to the second (0.409 ± 0.063 vs. 0.536 ± 0.064, p < 0.0001) and the third (0.409 ± 0.063 vs. 0.528 ± 0.055, p = 0.0001). Moreover, with the second protocol, we observed lower values during the first two measurements in comparison to the third measurement (p = 0.0279 and p = 0.0054). Regarding protocols three and four, we recorded higher values for the second and third measurements than the first one, with higher values for the third measurement than the second one. In the fifth protocol, there were no significant statistical differences between the three consecutive measurements (p = 0.953, p = 0.742, and p = 0.897). Further, we examined the variations in sample thickness determined using each of the protocols proposed for the digital vernier caliper, as well as the values obtained with the digital thickness gauge protocol. As a result, during the first and second measurements, we observed lower thickness values for the venous wall samples using the first four protocols compared to the fifth protocol (for all p < 0.05). However, no differences were noted between the five protocols during the third measurement. Conclusions The digital thickness gauge Mitutoyo 547-500S provided superior accuracy with no difference between three successive measurements of venous wall thickness, regardless of the examiner's experience. Accurately determining the thickness of venous specimens is crucial for calculating the tissue's biomechanical properties.

Creation of a replicable anatomic model of terrible triad of the elbow.

BACKGROUND: Terrible triad of the elbow (TTE) is a complex dislocation associating radial head (RH) and coronoid process (CP) fractures. There is at present no reproducible anatomic model for TTE, and pathophysiology is unclear. The main aim of the present study was to create and validate an anatomic model of TTE. Secondary objectives were to assess breaking forces and relative forearm rotation with respect to the humerus before dislocation. METHODS: An experimental comparative study was conducted on 5 fresh human specimens aged 87.4 ± 8.6 years, testing 10 upper limbs. After dissection conserving the medial and lateral ligaments, interosseous membrane and joint capsule, elbows were reproducibly positioned in maximal pronation and 15° flexion, for axial compression on a rapid (100 mm/min) or slow (10 mm/min) protocol, applied by randomization between the two elbows of a given cadaver, measuring breaking forces and relative forearm rotation with respect to the humerus before dislocation. RESULTS: The rapid protocol reproduced 4 posterolateral and 1 divergent anteroposterior TTE, and the slow protocol 5 posterolateral TTE. Mean breaking forces were 3,126 ± 1,066 N for the lateral collateral ligament (LCL), 3,026 ± 1,308 N for the RH and 2,613 ± 1,120 N for the CP. Comparing mean breaking forces for all injured structures in a given elbow on the rapid protocol found a p-value of 0.033. Comparison of difference in breaking forces in the three structures (LCL, RH and CP) between the slow and rapid protocols found a mean difference of -4%. Mean relative forearm rotation with respect to the humerus before dislocation was 1.6 ± 1.2° in external rotation. CONCLUSIONS: We create and validate an anatomic model of TTE by exerting axial compression on an elbow in 15° flexion and maximal pronation at speeds of 100 and 10 mm/min.

A cross-species framework for classifying sound-movement couplings.

Sound and movement are entangled in animal communication. This is obviously true in the case of sound-constituting vibratory movements of biological structures which generate acoustic waves. A little less obvious is that other moving structures produce the energy required to sustain these vibrations. In many species, the respiratory system moves to generate the expiratory flow which powers the sound-constituting movements (sound-powering movements). The sound may acquire additional structure via upper tract movements, such as articulatory movements or head raising (sound-filtering movements). Some movements are not necessary for sound production, but when produced, impinge on the sound-producing process due to weak biomechanical coupling with body parts (e.g., respiratory system) that are necessary for sound production (sound-impinging movements). Animals also produce sounds contingent with movement, requiring neuro-physiological control regimes allowing to flexibly couple movements to a produced sound, or coupling movements to a perceived external sound (sound-contingent movement). Here, we compare and classify the variety of ways sound and movements are coupled in animal communication; our proposed framework should help structure previous and future studies on this topic.

The Integral Theory, Pelvic Floor Biomechanics, and Binary Innervation.

The pelvic floor biomechanics and sphincter functioning are essential for understanding pelvic floor dysfunction and the pathophysiology of the pelvic organs. The pelvic floor consists of muscles, fascial connections and ligaments. The Integral Theory Paradigm (ITP) explains the musculoskeletal entity of the sphincter mechanism and the pathophysiology of pelvic organ function. The ITP explains the pelvic floor function determined by 3 directional muscle forces: forward, backwards and downward-acting muscle vector forces that form an anterior and posterior resultant. The resultant equilibrium is essential for urinary continence, voiding and defecation. Loose ligaments disturb the equilibrium of the pelvic floor's muscular function with consequences for the organ function's continence, evacuation, and sensory perception.

A Biomechanical Analysis of Oblique Metacarpal Metadiaphyseal Fracture Fixation in a Cadaver Model.

PURPOSE: Although metacarpal fractures are typically managed nonoperatively, when surgical management is indicated, metacarpal fractures are commonly treated with crossed Kirschner wires (K-wires), which may limit early range of motion. Intramedullary implants are increasing in use with the potential advantage of early range of motion; however, stability in oblique metacarpal neck fractures remains a theoretical concern. The purpose of this study was to determine the biomechanical stability of noncompressive intramedullary fixation for oblique metacarpal neck fractures compared with crossed K-wire fixation. METHODS: The index, long, and small metacarpals were harvested from three matched pairs of fresh-frozen cadavers. Oblique fractures at the metadiaphyseal region were created in each metacarpal. Each metacarpal was randomized to noncompressive, threaded intramedullary nail fixation or fixation with two crossed K-wires. Specimens were mounted in a Materials Testing System load frame and axially loaded until failure. Load to failure (LTF), stiffness, and load to 2 mm displacement were calculated from load-displacement curves. Differences in peak LTF, stiffness, and load to 2 mm displacement between noncompressive intramedullary fixation and crossed K-wire fixation were evaluated. RESULTS: The noncompressive intramedullary fixation cohort had a significantly higher LTF (1,190.9 ± 534.7 N vs 297.0 ± 156.0 N) and stiffness (551.3 ± 164.6 N/mm vs 283.0 ± 194.5 N/mm) when compared with the crossed K-wire fixation cohort. Load at 2 mm displacement was greater in the noncompressive intramedullary fixation cohort compared with crossed K-wire fixation (820.5 ± 203.9 vs 514.1 ± 259.6). CONCLUSIONS: For oblique metadiaphyseal metacarpal fractures, noncompressive intramedullary fixation provides a biomechanically superior construct under axial loading in terms of LTF, stiffness, and load to 2 mm of displacement compared with crossed K-wire fixation. CLINICAL RELEVANCE: Noncompressive intramedullary nails may be an alternative to K-wire fixation for the treatment of oblique metadiaphyseal metacarpal fractures.

The Molecular Mechanism of Macrophages in Response to Mechanical Stress.

Macrophages, a type of functionally diversified immune cell involved in the progression of many physiologies and pathologies, could be mechanically activated. The physical properties of biomaterials including stiffness and topography have been recognized as exerting a considerable influence on macrophage behaviors, such as adhesion, migration, proliferation, and polarization. Recent articles and reviews on the physical and mechanical cues that regulate the macrophage's behavior are available; however, the underlying mechanism still deserves further investigation. Here, we summarized the molecular mechanism of macrophage behavior through three parts, as follows: (1) mechanosensing on the cell membrane, (2) mechanotransmission by the cytoskeleton, (3) mechanotransduction in the nucleus. Finally, the present challenges in understanding the mechanism were also noted. In this review, we clarified the associated mechanism of the macrophage mechanotransduction pathway which could provide mechanistic insights into the development of treatment for diseases like bone-related diseases as molecular targets become possible.

How accurately do finite element models predict the fall impact response of ex vivo specimens augmented by prophylactic intramedullary nailing?

Hip fracture prevention approaches like prophylactic augmentation devices have been proposed to strengthen the femur and prevent hip fracture in a fall scenario. The aim of this study was to validate the finite element model (FEM) of specimens augmented by prophylactic intramedullary nailing in a simulated sideways fall impact against ex vivo experimental data. A dynamic inertia-driven sideways fall simulator was used to test six cadaveric specimens (3 females, 3 males, age 63-83 years) prophylactically implanted with an intramedullary nailing system used to augment the femur. Impact force measurements, pelvic deformation, effective pelvic stiffness, and fracture outcomes were compared between the ex vivo experiments and the FEMs. The FEMs over-predicted the effective pelvic stiffness for most specimens and showed variability in terms of under- and over-predicting peak impact force and pelvis compression depending on the specimen. A significant correlation was found for time to peak impact force when comparing ex vivo and FEM data. No femoral fractures were found in the ex vivo experiments, but two specimens sustained pelvic fractures. These two pelvis fractures were correctly identified by the FEMs, but the FEMs made three additional false-positive fracture identifications. These validation results highlight current limitations of these sideways fall impact models specific to the inclusion of an orthopaedic implant. These FEMs present a conservative strategy for fracture prediction in future applications. Further evaluation of the modelling approaches used for the bone-implant interface is recommended for modelling augmented specimens, alongside the importance of maintaining well-controlled experimental conditions.

A Robotic Clamped-Kinematic System to Study Knee Ligament Injury.

Knee ligament injury is among the most common sports injuries and is associated with long recovery periods and low return-to-sport rates. Unfortunately, the mechanics of ligament injury are difficult to study in vivo, and computational studies provide limited insight. The objective of this study was to implement and validate a robotic system capable of reproducing natural six degree-of-freedom clamped-kinematic trajectories on human cadaver knees (meaning that positions and orientations are rigidly controlled and resultant loads are measured). To accomplish this, we leveraged the field's recent access to high-fidelity bone kinematics from dynamic biplanar radiography (DBR), and implemented these kinematics in a coordinate frame built around the knee's natural flexion-extension axis. We assessed our system's capabilities in the context of ACL injury, by moving seven cadaveric knee specimens through kinematics derived from walking, running, drop jump, and ACL injury. We then used robotically simulated clinical stability tests to evaluate the hypothesis that knee stability would be only reduced by the motions intended to injure the knee. Our results show that the structural integrity of the knee was not compromised by non-injurious motions, while the injury motion produced a clinically relevant ACL injury with characteristic anterior and valgus instability. We also demonstrated that our robotic system can provide direct measurements of reaction loads during a variety of motions, and facilitate gross evaluation of ligament failure mechanisms. Clamped-kinematic robotic evaluation of cadaver knees has the potential to deepen understanding of the mechanics of knee ligament injury.

Mechanisms of gait speed changes in middle-aged adults: Simultaneous analysis of magnitude and temporal effects.

BACKGROUND: Middle-aged adults represent the transition between younger and older adults, where some of the characteristic gait differences due to aging begins to surface. However, the gait characteristics of middle-aged adults across the whole gait cycle remains an understudied topic. As speed is a sensitive indicator of health, characterizing the effects of speed on the gait of middle-aged adults and differentiating it from the response of young adults will provide insights into the effects of aging on gait speed modulation mechanisms. RESEARCH QUESTION: What are the mechanisms of gait speed changes that are employed by middle-aged adults, and how are they different from younger adults? METHODS: A cohort of healthy young and middle-aged adults completed 60 second trials at three different speeds. Joint kinematics, kinetics, and surface electromyography data were analyzed and compared between the speed levels and age groups. Statistical Parametric Mapping along with a nonlinear curve registration algorithm was used to simultaneously assess the changes in both magnitude and timing of different metrics. RESULTS: When compared to the younger cohort, the middle-aged cohort had significantly lower ankle range of motion, dorsiflexion moment during loading response and plantarflexion moment during push-off. At the knee joint, the middle-aged adults had significantly lower knee flexion moment during stance. At the hip joint, the middle-aged adults had lower extension moment during terminal stance. SIGNIFICANCE: Time-continuous analysis showed that primary differences due to age were related to decreased joint range of motion and joint moment production capability in the middle-aged adults. Faster walking appears a safe method for middle-aged adults to increase joint range of motion and joint moment expression. However, targeted interventions that focus on improving capability are likely also needed. Suggested targets being improving ankle and knee joint moment capability, and increased range of motion at all joints.

Effects of Aging on Patellofemoral Joint Stress during Stair Negotiation on Challenging Surfaces.

This study examined the effect of age and surface on patellofemoral joint (PFJ) stress magnitude and waveform during stair ascent and descent tasks. A total of 12 young and 12 older adults had knee biomechanics quantified while they ascended and descended stairs on normal, slick, and uneven surfaces. The peak of stance (0-100%) PFJ stress and associated components were submitted to a two-way repeated measures ANOVA, while the PFJ stress waveform was submitted to statistical parametric mapping two-way ANOVA. During stair ascent, older adults exhibited greater PFJ stress waveforms, from 55 to 59% and 74 to 84% of stance (p < 0.001) as well as greater PFJ stress-time integral across stance (p = 0.003), and later peak PFJ stress, than young adults (p = 0.002). When ascending on the uneven surface, participants exhibited smaller PFJ stress from 9 to 24% of stance compared to the normal surface, but greater PFJ stress from 75 to 88% and from 63 to 68% of stance (p < 0.001) as well as greater PFJ stress-time integrals compared to normal and slick surfaces (p < 0.032). During stair descent, older adults exhibited a smaller PFJ contact area range (p = 0.034) and peak knee flexion angle (p = 0.022) than young adults. When descending on the slick surface, participants exhibited smaller PFJ stress from 5 to 18% of stance, but greater stress, from 92 to 98% of stance (both: p < 0.001), compared to the normal surface. Negotiating slick and uneven stairs may produce knee biomechanics that increase PFJ stress, and the larger, later PFJ stress exhibited by older adults may further increase their risk of PFJ pain.

Using dynamic ultrasound to assess Achilles tendon mechanics during running: The effect on running pattern and muscle-tendon junction tracking.

Achilles tendon strain can be quantified using dynamic ultrasound, but its use in running is limited. Minimal effects on running pattern and acceptable test-retest reliability of muscle-tendon junction (MTJ) tracking are prerequisites for ultrasound use during running. We aimed to assess (i) the effect of wearing an ultrasound transducer on running pattern and (ii) the test-retest reliability of MTJ tracking during running. Sixteen long-distance runners (nine injury-free, seven with Achilles tendinopathy) ran at different speeds on an instrumented treadmill with a 10-camera system tracking skin-mounted retroreflective markers, first without and then with an ultrasound transducer attached to the lower leg to track the MTJ of the gastrocnemius medialis. Spatiotemporal parameters, joint kinematics and kinetics were compared between conditions using mixed ANOVAs and paired t-tests. MTJ tracking was performed manually twice by three raters in ten participants. Variability and standard error of measurement (SEM) quantified the inter- and intra-tester test-retest reliability. The running pattern was not affected by wearing the ultrasound transducer, except for significantly less knee flexion during midstance (1.6°) and midswing (2.9°) found when wearing the transducer. Inter-rater and intra-rater SEMs for MTJ tracking to assess the tendon strain (0.43%, and 0.56%, respectively) were about four times as low as between-group differences presented in literature. The minimal effects found on the running pattern and acceptable test-retest reliability indicates that dynamic ultrasound during running can be appropriately used to study Achilles tendon mechanics and thereby help improve our understanding of Achilles tendon behavior during running, injury development and recovery.

Biomechanics of the Human Knee Joint in Maximum Voluntary Isometric Flexion: Study of Changes in Applied Moment, Agonist-Antagonist Participations, Joint Center, and Flexion Angle.

Estimation of the knee joint strength by maximum voluntary isometric contraction (MVIC) is a common practice to assess strength, coordination, safety to return to work or engage in sports after an injury, and to evaluate the efficacy of treatment modalities and rehabilitation strategies. In this study, we utilize a previously validated coupled finite element-musculoskeletal model of the lower extremity to explore the sensitivity of output measures (posterior cruciate ligament [PCL]/muscle/contact forces and passive moments) in knee MVIC flexion exercises at seated position. To do so, at three knee flexion angles (KFA), input measures (resistance moment and contribution moments of quadriceps and gastrocnemii) were varied at four levels each using the Taguchi design of experiment. Our findings reveal significant increases in PCL forces with KFA (p < 0.01), net MVIC moment (p < 0.01), and resistance moment of quadriceps (p < 0.01). In contrast, they drop at larger activity in gastrocnemii (p < 0.01). Tibiofemoral (TF) contact forces increase with the net MVIC moment (p < 0.01). The passive knee flexion moment, while highly dependent on the location at which computed, also increases with the net MVIC moment (p < 0.01). Changes in KFA, MVIC moment, and proportions thereof carried by quadriceps and/or gastrocnemii substantially affect biomechanics of the joint. Compared with level walking and stair ascent, slightly larger contact forces/stresses and much greater PCL forces are computed. This study improves our understanding of the knee joint behavior during MVIC in effective evaluation and rehabilitation interventions. Besides, it emphasizes the importance of positioning the joint center in model studies.

Effects of eyelid pressure on corneal tomography and biomechanics: Quantitative analysis using a novel blepharo-tensiometer.

PURPOSE: This study aimed to validate a blepharo-tensiometer, and investigate the relationship between eyelid pressure (ELP) and corneal tomography/biomechanics. METHODS: Repeatability of the blepharo-tensiometer was evaluated at different inclination angles: 10°, 15°, and 20° for the upper eyelid (U10, U15, and U20) and 45°, 50°, and 55° for the lower eyelid (L45, L50, and L55). Reproducibility was evaluated in terms of different operators and inclination angles. Both the maximum and average ELP were evaluated. Best-corrected visual acuity, manifest refraction spherical equivalent, eyelid types, palpebral fissure height, exophthalmometry, axial length, and corneal tomographic/biomechanical parameters were measured. Spearman analysis and generalized estimating equations were used to explore potential correlations. RESULTS: This study included 36 eyes from 36 subjects. The ICCs for repeatability were comparable between different inclination angles, so U15 and L50 were selected for further analysis. The ICCs for reproducibility in terms of different operator or inclination angle also achieved good to excellent outcomes. Certain associations have been revealed between the ELP and corneal tomographic/biomechanical parameters. Tomographically, ELP influences corneal front J0, front asphericity, and the index of surface variance; whereas biomechanically, ELP affects the time at first applanation, deformation amplitude at highest concavity, and biomechanically corrected intraocular pressure. CONCLUSIONS: The tensiometer showed good precision. The study also showed that ELP causes a flattening effect on the peripheral cornea, with greater ELP linked to better corneal biomechanical properties in healthy subjects. These findings may potentially illuminate new avenues in the field of corneal disorders and beyond.

Measurement of maize stalk shear moduli.

Maize is the most grown feed crop in the United States. Due to wind storms and other factors, 5% of maize falls over annually. The longitudinal shear modulus of maize stalk tissues is currently unreported and may have a significant influence on stalk failure. To better understand the causes of this phenomenon, maize stalk material properties need to be measured so that they can be used as material constants in computational models that provide detailed analysis of maize stalk failure. This study reports longitudinal shear modulus of maize stalk tissue through repeated torsion testing of dry and fully mature maize stalks. Measurements were focused on the two tissues found in maize stalks: the hard outer rind and the soft inner pith. Uncertainty analysis and comparison of multiple methodologies indicated that all measurements are subject to low error and bias. The results of this study will allow researchers to better understand maize stalk failure modes through computational modeling. This will allow researchers to prevent annual maize loss through later studies. This study also provides a methodology that could be used or adapted in the measurement of tissues from other plants such as sorghum, sugarcane, etc.

Systematic video analysis of ACL injuries in professional Spanish male football (soccer): injury mechanisms, situational patterns, biomechanics and neurocognitive errors - a study on 115 consecutive cases.

Objective: A few video analysis studies have been published in recent years, but none specifically on Spanish football. We aimed to describe the mechanisms, situational patterns, biomechanics and neurocognitive errors related to anterior cruciate ligament (ACL) injuries in professional Spanish football matches. Methods: We identified 167 consecutive ACL injuries across 12 seasons of the top two leagues in Spanish football. 115 (69%) injury videos were analysed for mechanism and situational pattern, while biomechanical analysis was possible in 81 cases. Neurocognitive errors were investigated for all non-contact injuries. Three independent reviewers evaluated each video. ACL injury epidemiology-month, timing within the match and pitch location at the time of injury was also documented. Results: More injuries occurred in defensive (n=68, 59%) than offensive (n=48, 41%) (p<0.01) playing situations. 16 (14%) injuries were direct contact, 49 (43%) indirect contact and 50 (43%) non-contact. Most injuries (89%) occurred during four main situational patterns: (1) pressing/tackling (n=47, 47%); (2) tackled (n=23, 23%); (3) landing from a jump (n=12, 12%) and regaining balance after kicking (n=6, 6%). Injuries generally involved a knee-dominant loading strategy in the sagittal plane with abducted hip and knee valgus. Of the non-contact injuries, 39 (78%) were deemed to involve a neurocognitive error. More (58%) injuries occurred in the first half of matches (p<0.01). Conclusions: ACL injuries in Spanish football occurred similarly with non-contact and indirect contact mechanisms (44%). Four in five non-contact injuries involved a neurocognitive error. Most injuries occurred during four previously identified situational patterns, with more injuries earlier in the match.

Reliability of motion phase identification for long-track speed skating using inertial measurement units.

Background: Precise identification of motion phases in long-track speed skating is critical to characterize and optimize performance. This study aimed to estimate the intra- and inter-rater reliability of movement phase identification using inertial measurement units (IMUs) in long-track speed skating. Methods: We analyzed 15 skaters using IMUs attached to specific body locations during a 500m skate, focusing on the stance phase, and identifying three movement events: Onset, Edge-flip, and Push-off. Reliability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis. Results: Results showed high intra- and inter-rater reliability (ICC [1,1]: 0.86 to 0.99; ICC [2,1]: 0.81 to 0.99) across all events. Absolute error ranged from 0.56 to 6.15 ms and from 0.92 to 26.29 ms for intra- and inter-rater reliability, respectively. Minimally detectable change (MDC) ranged from 17.56 to 62.22 ms and from 33.23 to 131.25 ms for intra- and inter-rater reliability, respectively. Discussion: Despite some additive and proportional errors, the overall error range was within acceptable limits, indicating negligible systematic errors. The measurement error range was small, demonstrating the accuracy of IMUs. IMUs demonstrate high reliability in movement phase identification during speed skating, endorsing their application in sports science for enhanced kinematic studies and training.