Biomechanical analysis and modeling of lumbar belt: Preliminary study.

International audienceLow back pain is a major public health problem in European Countries. In France, about 50% of population is suffering of this pathology every year (Fassier 2011). Because of health care cost and sick leave (Fassier 2011; Leclerc et al. 2009), low back pain has both societal and economic adverse consequences. Many treatments are proposed. However no guideline is provided to physician. Treatment depends on patient, on low back pain type and evolution and also on physician knowledge and believes. Medical devices, as lumbar belt might be proposed to treat low back pain. Several clinical trials have shown their efficacy (Calmels et al. 2009). Nevertheless, both mechanical and physiological effects of lumbar belts remain unclear. In this study, the application of a lumbar belt on the trunk is simulated by a finite element model. It is often assumed that the pain comes from the toe of the intervertebral discs and is related only to the intradiscal pressure and the thoracolumbar posture. Beside, abdominal pressure is used by belt manufacturers as a marker of the lumbar belt efficiency, because a change in the abdominal pressure could bring a change in the thoracolumbar posture and consequently on the intradiscal pressure. That's why the goal of this study is to determine the mechanical effect of wearing lumbar belt: i) on abdominal pressure; ii) on thoracolumbar posture; iii) on intervertebral disc pressure

Efficiency and comfort of knee braces: A parametric study based on computational modelling

International audienceKnee orthotic devices are widely proposed by physicians and medical practitioners for preventive or therapeutic objectives in relation with their effects, usually known as to stabilize joint or restrict ranges of motion. This study focuses on the understanding of force transfer mechanisms from the brace to the joint thanks to a Finite Element Model. A Design Of Experiments approach was used to characterize the stiffness and comfort of various braces in order to identify their mechanically influent characteristics. Results show conflicting behavior: influent parameters such as the brace size or textile stiffness improve performance in detriment of comfort. Thanks to this computational tool, novel brace designs can be tested and evaluated for an optimal mechanical efficiency of the devices and a better compliance of the patient to the treatment

Efficiency of knee braces: A biomechanical approach based on computational modeling.

International audienceThe knee is the largest joint in the body and is vulnerable to injury during athletic activities or to musculoskeletal conditions such as arthrosis. Knee orthotic devices are widely used by physicians as preventive and therapeutic adjuncts for both musculoskeletal conditions and sport injuries. Their goal is to stabilize or restrict non-physiological knee ranges of motion. The efficiency of these devices has been studied both from clinical and biomechanical perspectives, leading to controversial results from questionable methods. As for now, the mechanisms of force transfer from the device to the joint bones have never been characterized and both device manufacturers and clinicians still expect a standard procedure to compare and grade the efficiency of different knee braces. The objectives of this work are: 1. to quantify the mechanical reactions of knee braces against non-physiological movements; 2. to relate these mechanical reactions to the pressure applied by the braces onto the skin. The latter is particularly important because it refers to comfort issues, which play a key role in a patient's compliance to the orthopedic treatment. A Finite Element Model of a braced human leg is developed. The model is first applied for characterizing the behavior of different kinds of knee braces, focusing on the mechanical reactions against non-physiological movements. In the model, a special attention is paid to the interfaces between knee-braces and the skin and between the skin and the muscles. The interface properties of the model are calibrated against experimental data measured by full-field measurements of 3D displacement over the surface of a patient's leg. The results show that the mechanical action of knee braces is essentially limited by skin/fabric and skin/muscles sliding. Finally, the model leads to a better understanding of the knee/brace interaction, and of the role of the brace components on the stability of the injured knee. Thanks to this computational tool, novel brace designs can be tested and evaluated for an optimal mechanical efficiency of the devices. Future work consists in considering the patient's comfort in the approach

Le modele du PETTLEP ou comment optimiser l’efficacite de l’imagerie mentale

Le modèle du PETTLEP, modèle élaboré par deux chercheurs et psychologues du sport britanniques, nous offre une approche inhabituelle et novatrice de l’imagerie. Ce modèle permet d’améliorer la compréhension des processus impliqués dans l’imagerie mentale et d’optimiser ainsi son utilisation et son efficacité. Les grands principes de cette approche ont été et sont actuellement mis en application auprès des gymnastes féminines du pôle France INSEP

Effects of Visual Context upon Functional Connectivity during Observation of Biological Motions

International audienceThe aim of this study was to examine brain responses, in particular functional connectivity, to different visual stimuli depicting familiar biological motions. Ten subjects actively observed familiar biological motions embedded in point-light and video displays. Electroencephalograms were recorded from 64 electrodes. Activity was considered in three frequency bands (4–8 Hz, 8–10 Hz, and 10–13 Hz) using a non-linear measure of functional connectivity. In the 4–8 Hz and 8–10 Hz frequency bands, functional connectivity for the SMA was greater during the observation of biological motions presented in a point-light display compared to the observation of motions presented in a video display. The reverse was observed for the 4–8 Hz frequency band for the left temporal area. Explanations related to: (i) the task demands (i.e., attention and mental effort), (ii) the role(s) of theta and alpha oscillations in cognitive processes, and (iii) the function(s) of cortical areas are discussed. It has been suggested that attention was required to process human biological motions under unfamiliar viewing conditions such as point-light display

Eye gaze metrics reflect a shared motor representation for action observation and movement imagery

Action observation (AO) and movement imagery (MI) have been reported to share similar neural networks. This study investigated the congruency between AO and MI using the eye gaze metrics, dwell time and fixation number. A simple reach-grasp-place arm movement was observed and, in a second condition, imagined where the movement was presented from the first person perspective (1PP) and the third person perspective (3PP). Dwell time and number of fixations were calculated for whole scene and regions of interest (ROIs). For whole scene, no significant differences were found in the number of fixations for condition (AO, MI) or perspective. Dwell time, however, was significantly longer in AO than MI. For ROIs, the number of fixations was significantly greater in 1PP than 3PP. The data provide support for congruence between motor simulation states but also indicate some functional differences

Active Vision during Action Execution, Observation and Imagery: Evidence for Shared Motor Representations

The concept of shared motor representations between action execution and various covert conditions has been demonstrated through a number of psychophysiological modalities over the past two decades. Rarely, however, have researchers considered the congruence of physical, imaginary and observed movement markers in a single paradigm and never in a design where eye movement metrics are the markers. In this study, participants were required to perform a forward reach and point Fitts’ Task on a digitizing tablet whilst wearing an eye movement system. Gaze metrics were used to compare behaviour congruence between action execution, action observation, and guided and unguided movement imagery conditions. The data showed that participants attended the same task-related visual cues between conditions but the strategy was different. Specifically, the number of fixations was significantly different between action execution and all covert conditions. In addition, fixation duration was congruent between action execution and action observation only, and both conditions displayed an indirect Fitts’ Law effect. We therefore extend the understanding of the common motor representation by demonstrating, for the first time, common spatial eye movement metrics across simulation conditions and some specific temporal congruence for action execution and action observation. Our findings suggest that action observation may be an effective technique in supporting motor processes. The use of video as an adjunct to physical techniques may be beneficial in supporting motor planning in both performance and clinical rehabilitation environments

Screen Position Preference Offers a New Direction for Action Observation Research: Preliminary Findings Using TMS

Action observation has been suggested to be an effective adjunct to physical practice in motor (re)learning settings. However, optimal viewing conditions for interventions are yet to be established. Single-pulse transcranial magnetic stimulation (TMS) was used to investigate the effect of two different screen positions and participants’ screen position viewing preference on the amplitude of motor evoked potentials (MEPs) during observation of a ball pinch action. Twenty-four participants observed four blocked conditions that contained either a dynamic index finger-thumb ball pinch or a static hand holding a ball in a similar position on a horizontally or vertically positioned screen. TMS was delivered to the hand representation of the left primary motor cortex and MEPs were recorded from the first dorsal interosseous muscle of the right hand. Initial analysis of the normalized MEP amplitude data showed no significant differences between conditions. In a follow-up procedure, participants engaged in individual semi-structured interviews and completed a questionnaire designed to assess viewing affect and screen position viewing preference. The MEP data were subsequently split by screen position preference and re-analyzed using a 2 × 2 repeated measures ANOVA. Main effects indicated that participants who preferred the horizontal screen position (n = 16) demonstrated significantly greater MEP amplitudes during observation of the ball-pinch action compared to the static hand condition irrespective of screen position, and during the horizontal compared to the vertical screen position irrespective of video type. These results suggest that ensuring anatomical and perceptual congruency with the physical task, alongside consideration of participants’ screen position viewing preferences, may be an important part of optimizing action observation interventions

The influence of early aging on eye movements during motor simulation

Movement based interventions such as imagery and action observation are used increasingly to support physical rehabilitation of adults during early aging. The efficacy of these more covert approaches is based on an intuitively appealing assumption that movement execution, imagery and observation share neural substrate; alteration of one influences directly the function of the other two. Using eye movement metrics this paper reports findings that question the congruency of the three conditions. The data reveal that simulating movement through imagery and action observation may offer older adults movement practice conditions that are not constrained by the age-related decline observed in physical conditions. In addition, the findings provide support for action observation as a more effective technique for movement reproduction in comparison to imagery. This concern for imagery was also seen in the less congruent temporal relationship in movement time between imagery and movement execution suggesting imagery inaccuracy in early aging