Kinetic strategies of patients with shoulder impingement syndrome.

Our aim was to determine whether subjects with shoulder impingement syndrome (SIS) have abnormal multijoint torque patterns compared to healthy subjects during normalized isometric force along specific directions. Subjects had to generate an isometric force corresponding to 40% of the maximal pain-free force. Eight targets were displayed on a monitor (0, 45, 90, 135, 180, 225, 270, and 315 degrees ). We calculated shoulder and elbow torques (kinetic strategies) using a biomechanical model. Regardless of the target location, the SIS group succeeded in reaching the target; however, when compared to the healthy subjects, they needed more time to do so, suggesting that SIS may slow down the execution of the kinetic strategies. Moreover, the SIS group produced lower shoulder external/internal torque to reach the targets located at 0 degrees and 225 degrees, and they generated greater abduction/adduction torque for targets located at 0, 135, and 180 degrees. In addition, they had lower elbow extension/flexion torque for the target located at 315 degrees. The investigation of atypical kinetic strategies is essential to provide an understanding of the pathomechanics of the SIS and to develop more effective treatment strategies.

Role of loading on head stability and effective neck stiffness and viscosity.

This experiment tests the hypothesis that loading the head would increase head stability. In particular, we hypothesized that an arrangement of the head so that muscle activation is required to counteract a load would significantly increase effective neck stiffness and viscosity, which would be associated with lower peak head angular velocity following abrupt force perturbations applied to the head. Seven young healthy subjects had their head loaded (preload) using a weight/pulley apparatus. Then, the head was pulled either forward or backward by dropping an additional weight onto the preload, causing an impulse of force followed by an increase in load. We recorded the applied force and head angular velocity. Neck viscoelastic properties as a function of loading were estimated by fitting experimental data to a second-order mathematical model of the head biomechanics. Across preloads varying from 2.22 to 8.89 N, peak head angular velocity decreased by 18.2% for the backward and by 19.9% for forward perturbations. As preload increased, simulated effective neck stiffness and viscosity significantly increased leading to lower peak angular velocity. These results demonstrated that loading reduces peak head angular velocity and that change in muscle stiffness and viscosity is a feasible explanation for this effect. We propose that reduction in peak head velocity could be caused by modulation of the strength of the vestibulo-collic reflex.

Modelling liver tissue properties using a non-linear visco-elastic model for surgery simulation.

In this work, we introduce an extension of the linear elastic tensor-mass method allowing fast computation of non-linear and visco-elastic mechanical forces and deformations for the simulation of biological soft tissue. We aim at developing a simulation tool for the planning of cryogenic surgical treatment of liver cancer. Percutaneous surgery simulation requires accurate modelling of the mechanical behaviour of soft tissue, and previous experimental characterizations have shown that linear elasticity is only a coarse approximation of the real properties of biological tissues. We first show that our model can simulate different types of non-linear and visco-elastic mechanical behaviours at speeds which are compatible with real-time applications. Then an experimental setup is presented which was used to characterize the mechanical properties of deer liver tissue under perforation by a biopsy needle. Experimental results demonstrate that a linear model is not suitable for simulating this application, while the proposed model succeeds in accurately modelling the axial load measured on the needle.