Comparison of in vivo human knee joint kinematics using axodes

The human knee is of particular interest because of its importance in mobility. Pain and stability can be directly related to the motion, or kinematics, of the knee. Many studies have been conducted to quantify human knee kinematics, both in vitro and in vivo. One of the inherent issues with in vivo, skin mounted measurement systems is that they do not account for soft tissue artifact. Compensation for soft tissue artifact has been a difficult challenge for skin mounted tracking systems and has not yet been achieved. Therefore, bone mounted skeletal pins were chosen as the method of gathering kinematic data for this study. Mounting bone pins is not the quintessential method to study motion due to its invasive nature; nevertheless, it provides a great amount of trustworthy, useful insight. Murphy conducted an in vivo experiment to capture the 3D kinematics of the normal human knee. The kinematic data were used to find the Instantaneous Screw Axis or Instantaneous Helical Axes (IHA). If progressive IHA’s are plotted on the same plot, the surface that is created is called the moving axode of the motion. Several degrees of freedom are needed to accurately describe the kinematics of the human knee during normal movement. The current study further analyzes the data that Murphy reported in 1990. The goal is to find an effective way to express kinematic information in a coordinate system-independent manner so that comparison is meaningful and feasible between gait/ROM trials, subjects, and knee repair/replacement methods. Axodes were used to compare knee kinematics, trial to trial, for gait, range of motion (ROM), and pivot step. It was established that 6 independent screws are required to fully describe the motion during gait. Thus, the knee behaves like a 6 DOF mechanism during gait and, therefore, two-, three-, four-, or five-screw system models are insufficient to adequately and uniquely define the screw system. Screw invariants were found to be a viable option of understanding knee kinematics. Axodes were plotted with pre-stance, stance phase, and post-stance phase indicated. Screw invariants, pitch and moment, were plotted as a function of flexion angle

Representation of planar motion of complex joints by means of rolling pairs. Application to neck motion

[EN] We propose to model planar movements between two human segments by means of rolling-without-slipping kinematic pairs. We compute the path traced by the instantaneous center of rotation (ICR) as seen from the proximal and distal segments, thus obtaining the fixed and moving centrodes, respectively. The joint motion is then represented by the rolling-without-slipping of one centrode on the other. The resulting joint kinematic model is based on the real movement and accounts for nonfixed axes of rotation; therefore it could improve current models based on revolute pairs in those cases where joint movement implies displacement of the ICR. Previous authors have used the ICR to characterize human joint motion, but they only considered the fixed centrode. Such an approach is not adequate for reproducing motion because the fixed centrode by itself does not convey information about body position. The combination of the fixed and moving centrodes gathers the kinematic information needed to reproduce the position and velocities of moving bodies. To illustrate our method, we applied it to the flexion-extension movement of the head relative to the thorax. The model provides a good estimation of motion both for position variables (mean R pos=0.995) and for velocities (mean R vel=0.958). This approach is more realistic than other models of neck motion based on revolute pairs, such as the dual-pivot model. The geometry of the centrodes can provide some information about the nature of the movement. For instance, the ascending and descending curves of the fixed centrode suggest a sequential movement of the cervical vertebrae. © 2010 Elsevier Ltd.This work was funded by the Spanish Government and co-financed by EU FEDER funds (Grants DPI2006-14722-C02-01, DPI2006-14722-C02-02, DPI2009-13830-C02-01, DPI2009-13830-C02-02 and Ramon y Cajal contract to JAG).Page Del Pozo, AF.; De Rosario Martínez, H.; Galvez Griso, JA.; Mata Amela, V. (2011). Representation of planar motion of complex joints by means of rolling pairs. Application to neck motion. Journal of Biomechanics. 44(4):747-750. https://doi.org/10.1016/j.jbiomech.2010.11.019S74775044

Quantification of knee extensor muscle forces: a multimodality approach

Given the growing interest of using musculoskeletal (MSK) models in a large number of clinical applications for quantifying the internal loading of the human MSK system, verification and validation of the model’s predictions, especially at the knee joint, have remained as one of the biggest challenges in the use of the models as clinical tools. This thesis proposes a methodology for more accurate quantification of knee extensor forces by exploring different experimental and modelling techniques that can be used to enhance the process of verification and validation of the knee joint model within the MSK models for transforming the models to a viable clinical tool. In this methodology, an experimental protocol was developed for simultaneous measurement of the knee joint motion, torques, external forces and muscular activation during an isolated knee extension exercise. This experimental protocol was tested on a cohort of 11 male subjects and the measurements were used to quantify knee extensor forces using two different MSK models representing a simplified model of the knee extensor mechanism and a previously-developed three-dimensional MSK model of the lower limb. The quantified knee extensor forces from the MSK models were then compared to evaluate the performance of the models for quantifying knee extensor forces. The MSK models were also used to investigate the sensitivity of the calculated knee extensor forces to key modelling parameters of the knee including the method of quantifying the knee centre of rotation and the effect of joint translation during motion. In addition, the feasibility of an emerging ultrasound-based imaging technique (shear wave elastography) for direct quantification of the physiologically-relevant musculotendon forces was investigated. The results in this thesis showed that a simplified model of the knee can be reliably used during a controlled planar activity as a computationally-fast and effective tool for hierarchical verification of the knee joint model in optimisation-based large-scale MSK models to provide more confidence in the outputs of the models. Furthermore, the calculation of knee extensor muscle forces has been found to be sensitive to knee joint translation (moving centre of rotation of the knee), highlighting the importance of this modelling parameter for quantifying physiologically-realistic knee muscle forces in the MSK models. It was also demonstrated how the movement of the knee axis of rotation during motion can be used as an intuitive tool for understanding the functional anatomy of the knee joint. Moreover, the findings in this thesis indicated that the shear wave elastography technique can be potentially used as a novel method for direct quantification of the physiologically-relevant musculotendon forces for independent validation of the predictions of musculotendon forces from the MSK models.Open Acces

Apport d’une évaluation biomécanique 3D du genou dans la prise en charge orthopédique de patients ayant une rupture du ligament croisé antérieur

Parmi les blessures sportives reliées au genou, 20 % impliquent le ligament croisé antérieur (LCA). Le LCA étant le principal stabilisateur du genou, une lésion à cette structure engendre une importante instabilité articulaire influençant considérablement la fonction du genou. L’évaluation clinique actuelle des patients ayant une atteinte au LCA présente malheureusement des limitations importantes à la fois dans l’investigation de l’impact de la blessure et dans le processus diagnostic. Une évaluation biomécanique tridimensionnelle (3D) du genou pourrait s’avérer une avenue innovante afin de pallier à ces limitations. L’objectif général de la thèse est de démontrer la valeur ajoutée du domaine biomécanique dans (1) l’investigation de l’impact de la blessure sur la fonction articulaire du genou et dans (2) l’aide au diagnostic. Pour répondre aux objectifs de recherche un groupe de 29 patients ayant une rupture du LCA (ACLD) et un groupe contrôle de 15 participants sains ont pris part à une évaluation biomécanique 3D du genou lors de tâches de marche sur tapis roulant. L’évaluation des patrons biomécaniques 3D du genou a permis de démontrer que les patients ACLD adoptent un mécanisme compensatoire que nous avons intitulé pivot-shift avoidance gait. Cette adaptation biomécanique a pour objectif d’éviter de positionner le genou dans une condition susceptible de provoquer une instabilité antérolatérale du genou lors de la marche. Par la suite, une méthode de classification a été développée afin d’associer de manière automatique et objective des patrons biomécaniques 3D du genou soit au groupe ACLD ou au groupe contrôle. Pour cela, des paramètres ont été extraits des patrons biomécaniques en utilisant une décomposition en ondelettes et ont ensuite été classifiés par la méthode du plus proche voisin. Notre méthode de classification a obtenu un excellent niveau précision, de sensibilité et de spécificité atteignant respectivement 88%, 90% et 87%. Cette méthode a donc le potentiel de servir d’outil d’aide à la décision clinique. La présente thèse a démontré l’apport considérable d’une évaluation biomécanique 3D du genou dans la prise en charge orthopédique de patients présentant une rupture du LCA; plus spécifiquement dans l’investigation de l’impact de la blessure et dans l’aide au diagnostic.The anterior cruciate ligament (ACL) is involved in approximately 20% of all sports-related knee injuries. An injury to the ACL, the primary stabilizer of the knee, will lead to knee joint instability and functional impairment. Unfortunately, current clinical assessments of ACL-deficient patients present limitations with respect to the investigation of the impact of the injury on knee function. A 3D knee biomechanical assessment could provide innovative information to overcome these drawbacks. The main objective of the doctoral theses is to demonstrate the role of biomechanics in (1) the investigation of the impact of the injury on knee function and in (2) the diagnostic process. Twenty-nine ACL-deficient patients and a control group of fifteen healthy participants took part in a 3D knee biomechanical assessment during treadmill walking. By assessing the 3D knee biomechanical patterns of each group we observed that ACL-deficient patients adopted a gait compensatory mechanism: the Pivot-shift avoidance gait. The explanation for this adaptative strategy is to avoid placing the knee in a position biomechanically favorable to anterolateral rotatory instability during gait. Furthermore, an automatic classification method capable of distinguishing ACL deficient patients from an asymptomatic population was developed. Features were extracted from the 3D knee biomechanical patterns using a wavelet decomposition method and then classified by the nearest neighbour rule. The proposed classification method obtained a level of accuracy, sensitivity and specificity of 88%, 90% and 87% respectively. This method shows great potential as a diagnostic aid in a clinical setting. This thesis demonstrates that biomechanics plays a substantial role in the management of ACL injuries by improving the understanding of the impact of the injury on knee function and by its capacity to serve as a diagnostic aid

Evaluating footwear “in the wild”: Examining wrap and lace trail shoe closures during trail running

Trail running participation has grown over the last two decades. As a result, there have been an increasing number of studies examining the sport. Despite these increases, there is a lack of understanding regarding the effects of footwear on trail running biomechanics in ecologically valid conditions. The purpose of our study was to evaluate how a Wrap vs. Lace closure (on the same shoe) impacts running biomechanics on a trail. Thirty subjects ran a trail loop in each shoe while wearing a global positioning system (GPS) watch, heart rate monitor, inertial measurement units (IMUs), and plantar pressure insoles. The Wrap closure reduced peak foot eversion velocity (measured via IMU), which has been associated with fit. The Wrap closure also increased heel contact area, which is also associated with fit. This increase may be associated with the subjective preference for the Wrap. Lastly, runners had a small but significant increase in running speed in the Wrap shoe with no differences in heart rate nor subjective exertion. In total, the Wrap closure fit better than the Lace closure on a variety of terrain. This study demonstrates the feasibility of detecting meaningful biomechanical differences between footwear features in the wild using statistical tools and study design. Evaluating footwear in ecologically valid environments often creates additional variance in the data. This variance should not be treated as noise; instead, it is critical to capture this additional variance and challenges of ecologically valid terrain if we hope to use biomechanics to impact the development of new products

Biomedical Sensing and Imaging

This book mainly deals with recent advances in biomedical sensing and imaging. More recently, wearable/smart biosensors and devices, which facilitate diagnostics in a non-clinical setting, have become a hot topic. Combined with machine learning and artificial intelligence, they could revolutionize the biomedical diagnostic field. The aim of this book is to provide a research forum in biomedical sensing and imaging and extend the scientific frontier of this very important and significant biomedical endeavor

Monitoring Welfare in Captive Chimpanzees (Pan Troglodytes) Using Individual Positional Behavior and Substrate Use Profiles

The welfare of captive chimpanzees partly depends on the structural features present in their enclosure. An individual’s manner of expressing positional behaviors depends on these environmental characteristics and may be reflective of their physical and mental health. This thesis seeks to further the scientific understanding of the relationships between positional behavior, substrate use and captive chimpanzee welfare. In pursuit of this goal, I designed and installed a novel vertical climbing aid onto a climbable platform structure within an enclosure at the chimpanzee sanctuary, Chimp Haven, in an effort to encourage mobility and vertical space use in the enclosure’s residents. Additionally, I assessed the chimpanzees’ tendencies for engaging in positional behaviors and using present substrates and enclosure areas. Finally, I examined the associations between particular substrates and the expressions of positional behaviors. The vertical climbing aid\u27s effectiveness was assessed by reviewing video recordings of the two platform structures within the enclosure before and after the installation. Positional behavior and substrate use data were recorded for each subject via focal animal scan sampling. The novel climbing aid was not effective during the study’s duration. Occupation rates and elevation level change frequencies decreased on the experimental structure. Alternative approaches should be taken to future structural modification designs, implementations, and assessments. Individuals demonstrated unique profiles of positional behaviors and substrate use tendencies. The detailed positional behavior profiles and diversity could be useful in assessing and promoting physical health and welfare once validated with established welfare measures and medical records. Substrate use profiles and diversity metrics could similarly be used to determine the degree to which individuals avoid or are receptive to various stimuli. Hence, changes to substrate use profiles can be monitored to assess progress in efforts to encourage individuals to embrace diverse experiences as is the goal of provisioning enrichment. Finally, the associations between substrate use and positional behavior expression may be used to direct changes to enclosures based on the needs of its residents. Deficiencies in positional behaviors for a given chimpanzee may be addressed through the addition of substrates that are most associated with a desired positional behavior. This preliminary study outlines a new approach to measuring welfare as a function of positional behavior expression and environmental interactions. Future refinements to these methods are expected to contribute to the ability of captive management programs to infer a more complete understanding of the overall conditions of captive chimpanzees. Issues that impede a chimpanzee’s wellbeing may then be addressed with suitable captive management strategies and the informed installation of appropriate substrates to improve welfare

Low-Cost Sensors and Biological Signals

Many sensors are currently available at prices lower than USD 100 and cover a wide range of biological signals: motion, muscle activity, heart rate, etc. Such low-cost sensors have metrological features allowing them to be used in everyday life and clinical applications, where gold-standard material is both too expensive and time-consuming to be used. The selected papers present current applications of low-cost sensors in domains such as physiotherapy, rehabilitation, and affective technologies. The results cover various aspects of low-cost sensor technology from hardware design to software optimization