Trabecular bone adaptation to low-magnitude high-frequency loading in microgravity.

Exposure to microgravity causes loss of lower body bone mass in some astronauts. Low-magnitude high-frequency loading can stimulate bone formation on earth. Here we hypothesized that low-magnitude high-frequency loading will also stimulate bone formation under microgravity conditions. Two groups of six bovine cancellous bone explants were cultured at microgravity on a Russian Foton-M3 spacecraft and were either loaded dynamically using a sinusoidal curve or experienced only a static load. Comparable reference groups were investigated at normal gravity. Bone structure was assessed by histology, and mechanical competence was quantified using µCT and FE modelling; bone remodelling was assessed by fluorescent labelling and secreted bone turnover markers. Statistical analyses on morphometric parameters and apparent stiffness did not reveal significant differences between the treatment groups. The release of bone formation marker from the groups cultured at normal gravity increased significantly from the first to the second week of the experiment by 90.4% and 82.5% in response to static and dynamic loading, respectively. Bone resorption markers decreased significantly for the groups cultured at microgravity by 7.5% and 8.0% in response to static and dynamic loading, respectively. We found low strain magnitudes to drive bone turnover when applied at high frequency, and this to be valid at normal as well as at microgravity. In conclusion, we found the effect of mechanical loading on trabecular bone to be regulated mainly by an increase of bone formation at normal gravity and by a decrease in bone resorption at microgravity. Additional studies with extended experimental time and increased samples number appear necessary for a further understanding of the anabolic potential of dynamic loading on bone quality and mechanical competence.

Classification of forefoot plantar pressure distribution in persons with diabetes: a novel perspective for the mechanical management of diabetic foot?

BACKGROUND: The aim of this study was to identify groups of subjects with similar patterns of forefoot loading and verify if specific groups of patients with diabetes could be isolated from non-diabetics. METHODOLOGY/PRINCIPAL FINDINGS: Ninety-seven patients with diabetes and 33 control participants between 45 and 70 years were prospectively recruited in two Belgian Diabetic Foot Clinics. Barefoot plantar pressure measurements were recorded and subsequently analysed using a semi-automatic total mapping technique. Kmeans cluster analysis was applied on relative regional impulses of six forefoot segments in order to pursue a classification for the control group separately, the diabetic group separately and both groups together. Cluster analysis led to identification of three distinct groups when considering only the control group. For the diabetic group, and the computation considering both groups together, four distinct groups were isolated. Compared to the cluster analysis of the control group an additional forefoot loading pattern was identified. This group comprised diabetic feet only. The relevance of the reported clusters was supported by ANOVA statistics indicating significant differences between different regions of interest and different clusters. CONCLUSION/S SIGNIFICANCE: There seems to emerge a new era in diabetic foot medicine which embraces the classification of diabetic patients according to their biomechanical profile. Classification of the plantar pressure distribution has the potential to provide a means to determine mechanical interventions for the prevention and/or treatment of the diabetic foot.

An in vitro approach to the evaluation of foot-ankle kinematics: performance evaluation of a custom-built gait simulator.

Despite their well-known limitations, in vitro experiments have several benefits over in vivo techniques when exploring foot biomechanics under conditions characteristic of gait. In this study, we present a new setup for dynamic in vitro gait simulation that integrates a numerical model for generating the tibial kinematics control input, and we present an innovative methodology to measure full three-dimensional joint kinematics during gait simulations. The gait simulator applies forces to the tendons. Tibial kinematics in the sagittal plane is controlled using a numerical model that takes into account foot morphology. The methodology is validated by comparing joint rotations measured during gait simulation with those measured in vivo. In addition, reliability and accuracy of the control system as well as simulation input and output repeatability are quantified. The results reflect good control performance and repeatability of the control inputs, vertical ground reaction force, center of pressure displacement, and joint rotations and translations. In addition, there is a good correspondence to in vivo kinematics for most patterns of motion at the ankle, subtalar, and Chopart's joints. Therefore, these results show the relevance and validity of including specimen-specific information for defining the control inputs.

Transmission of whole-body vibration and its effect on muscle activation.

The aim of current study was to measure the transmission of whole-body vibration through the entire body and to relate this to body posture and induced muscular activation. Eight clinically healthy subjects performed 3 static body postures-high squat (135°), deep squat (110°), and erect stance, whereas vibration transmission was assessed over a wide range of accelerations (from 0.33 to 7.98 g) and frequencies (from 30 to 50 Hz). To assess the vibration transmission, 9 triaxial accelerometers were attached from the ankle up to the head and the root mean square of acceleration signal of each site-specific body point was calculated. Additionally, muscle activity from 7 lower limb muscles was recorded. The results showed a significant attenuation of the platform accelerations transmitted from the feet to the head. Compared with erect stance, knee bent posture significantly diminished vibration transmission at the hip, spine, and the head (p < 0.05). Vibration transmission to the spine was significantly lower in deep vs. high squat (p < 0.05), suggesting that further knee bending may reduce the risk of overloading the spine. Vibration increased the muscle activity in most leg and hip muscles during both squat postures, although, on average, no clear dose-response relationship between the acceleration and/or frequency and muscle response was found. The muscular activation of vastus medialis and rectus femoris showed clear negative correlation to the vibration transmission at the sternum. The specific vibration parameters used in the present study can be considered as safe and suitable for a training program. Moreover, the present results contribute to optimize the most advantageous whole-body vibration protocol and to determine the beneficial effects on muscle and bone.

Repeatability of a 3D multi-segment foot model protocol in presence of foot deformities.

Repeatability studies on 3D multi-segment foot models (3DMFMs) have mainly considered healthy participants which contrasts with the widespread application of these models to evaluate foot pathologies. The current study aimed at establishing the repeatability of the 3DMFM described by Leardini et al. in presence of foot deformities. Foot kinematics of eight adult participants were analyzed using a repeated-measures design including two therapists with different levels of experience. The inter-trial variability was higher compared to the kinematics of healthy subjects. Consideration of relative angles resulted in the lowest inter-session variability. The absolute 3D rotations between the Sha-Cal and Cal-Met seem to have the lowest variability in both therapists. A general trend towards higher σ(sess)/σ(trial) ratios was observed when the midfoot was involved. The current study indicates that not only relative 3D rotations and planar angles can be measured consistently in patients, also a number of absolute parameters can be consistently measured serving as basis for the decision making process.

Digital image processing of live/dead staining.

The quantification of live and dead cells in a substrate is often an essential step in cell biology research. A staining protocol that acts differently on live and on dead cells is applied and the number of cells visible is counted using a microscope. Often this counting is done manually or only evaluated qualitatively. If the number of samples to be analyzed is large, counting live and dead cells will become a labor intensive, and in some cases an unreliable, process. The manual procedure also discards potentially relevant information on the cells beyond their live or dead classification. For example, cell size, shape and distribution cannot be measured manually. Thus, developing a software routine to replace the counting process can result in an increase of both efficiency and quality of the data gathering process. Whether or not the time and/or money spent on creating a dedicated computer algorithm is worthwhile, depends on a large number of factors of which some are specific to the samples and some to the technical expertise available. In a large percentage of cases, creating a computer algorithm may be easier than expected. In order for the reader to correctly asses the difficulty level of his/her specific case, an outline on how to tackle the problem is presented within this chapter. The basic concepts of digital imaging, explained in a possible step by step approach, is offered. It is important to be able to estimate the difficulty level for each specific case. Based on a series of questions the potential of creating a computer algorithm can be offset by the costs to be expected.