Effects of cervical muscle fatigue on the perception of the subjective vertical and horizontal

Introduction: Cervical functional capacity outcome measures that are simple and reliable are urgently needed in order permit accurate assessment/reassessment during treatments and rehabilitation. Induced neck muscle fatigue has been shown to alter functional capacities such as balance and kinaesthetic sense in the standing posture. The Rod and Frame Test has also shown promise as a method of assessing the effects of chronic neck pain and injury, but currently only in the sitting position. The objectives of this project were therefore 1) to validate the computerised rod and frame test in the standing posture, and 2) to measure the effects that different cervical muscle fatigue protocol would have on the assessment of the subjective visual vertical and horizontal. Method: The validation of the standing computerised rod and frame test in the standing posture was obtained by comparing results (n = 74) between the sitting and standing positions with the Spearman's correlation coefficient. In addition, agreement between the two methods was analysed with the Bland-Altman method. Participants (n = 56) resisted with their neck muscles approximately 35% maximum isometric voluntary contraction force for 15 minutes on a purpose built apparatus in eight different directions. Wilcoxon signed rank tests analysed changes in horizontal and vertical rod and frame test between the neutral and all different directions of contraction. The changes of recorded unsigned vertical and horizontal errors for the combined frame condition in all situations of isometric contraction were analysed with two respective one-way repeated measures analysis of variance (ANOVA). Discussion: The Spearman's rho and Bland-Altman plots show that the Rod and Frame Test works equally well in sitting and standing positions. After muscle contraction, there were significant increases in error in all participants for both horizontal and vertical rod and frame tests, except after flexion. These errors were predominantly present after fatigue of muscles in the coronal plane of contraction. Proprioception alone cannot explain the difference in the rod and frame results between different muscle groups. It is suggested that an evolutionary advantage of developing improved subjective verticality awareness in the same direction as the main visual field could explain these findings. © 2014 Gosselin and Fagan

The effects of cervical muscle fatigue on balance - A study with elite amateur rugby league players

Neck muscle fatigue has been shown to alter an individual’s balance in a similar way to that reported in subjects suffering from neck pain or subjects that have suffered a neck injury. The main purpose of the present study was to quantify the effects of neck fatigue on neck muscle electromyography (EMG) activity, balance, perceived fatigue and perceived stability. Forty four elite amateur rugby league players resisted with their neck muscles approximately 35% maximum voluntary isometric contraction (MVIC) force for 15 minutes in eight different directions. Sway velocity and surface electromyography were measured. Questionnaires were used to record perceived effort and stability. Repeated measures ANOVA showed that after 15 minutes isometric contraction, significant changes were seen in sway velocity, perceived sway and EMG median frequency. There were no differences in perceived efforts. The changes in sway velocity and median frequency were more pronounced after extension and right and left posterior oblique contractions but there was no significant difference in sway velocity after contraction in the right lateral flexion, right anterior oblique and left anterior oblique direction of contraction. All the subjects showed oriented whole-body leaning in the plane of the contraction. The experiment produced significantly altered and perceived altered balance in this group of physically fit individuals. The results may contribute to our understanding of normal functional capacities of athletes and will provide a basis for further investigation in healthy non-athletes and participants that have suffered neck injuries. This may ultimately help develop accurate and valid rehabilitation outcome measures

Development and three-dimensional morphology of the zygomaticotemporal suture in primate skulls

Cranial sutures are an essential part of the growing skull, allowing bones to increase in size during growth, with their morphology widely believed to be dictated by the forces and displacements that they experience. The zygomaticotemporal suture in primates is located in the relatively weak zygomatic arch, and externally it appears a very simple connection. However, large forces are almost certainly transmitted across this suture, suggesting that it requires some level of stability while also allowing controlled movements under high loading. Here we examine the 2- and 3-dimensional (3D) morphology of the zygomaticotemporal suture in an ontogenetic series of Macaca fascicularis skulls. High resolution microcomputed tomography data sets were examined, and virtual and physical 3D replicas were created to assess both structure and general stability. The zygomaticotemporal suture is much more complex than its external appearance suggests, with interlocking facets between the adjacent zygomatic and temporal bones. It appears as if some movement is permitted across the suture in younger animals, but as they approach adulthood the complexity of the suture's interlocking bone facets reaches a level where these movements become minimal

A virtual approach to evaluate therapies for management of multiple myeloma induced bone disease: Modelling Therapies for Multiple Myeloma Induced Bone Disease

Multiple myeloma bone disease is devastating for patients and a major cause of morbidity. The disease leads to bone destruction by inhibiting osteoblast activity while stimulating osteoclast activity. Recent advances in multiple myeloma research have improved our understanding of the pathogenesis of multiple myeloma-induced bone disease and suggest several potential therapeutic strategies. However, the effectiveness of some potential therapeutic strategies still requires further investigation and optimization. In this paper, a recently developed mathematical model is extended to mimic and then evaluate three therapies of the disease, namely: bisphosphonates, bortezomib and TGF-β inhibition. The model suggests that bisphosphonates and bortezomib treatments not only inhibit bone destruction, but also reduce the viability of myeloma cells. This contributes to the current debate as to whether bisphosphonate therapy has an anti-tumour effect. On the other hand, the analyses indicate that treatments designed to inhibit TGF-β do not reduce bone destruction, although it appears that they might reduce the viability of myeloma cells, which again contributes to the current controversy regarding the efficacy of TGF-β inhibition in multiple myeloma-induced bone disease

Investigating the efficacy of bisphosphonates treatment against multiple myeloma induced bone disease using a computational model

Multiple myeloma (MM)-induced bone disease is mortal for most MM patients. Bisphosphonates are first-line treatment for MM-induced bone disease, since it can inhibit osteoclast activity and the resultant bone resorption by suppressing the differentiation of osteoclast precursors into mature osteoclasts, promoting osteoclast apoptosis and disrupting osteoclast function. However, it is still unclear whether bisphosphonates have an anti-tumour effect. In our previous work, a computational model was built to simulate the pathology of MM-induced bone disease. This paper extends this proposed computational model to investigate the efficacy of bisphosphonates treatment and then clear the controversy of this therapy. The extended model is validated through the good agreement between simulation results and experimental data. The simulation results suggest that bisphosphonates indeed have an anti-tumour effect

The effect of boundary constraints on finite element modelling of the human pelvis

The use of finite element analysis (FEA) to investigate the biomechanics of anatomical systems critically relies on the specification of physiologically representative boundary conditions. The biomechanics of the pelvis has been the specific focus of a number of FEA studies previously, but it is also a key aspect in other investigations of, for example, the hip joint or new design of hip prostheses. In those studies, the pelvis has been modelled in a number of ways with a variety of boundary conditions, ranging from a model of the whole pelvic girdle including soft tissue attachments to a model of an isolated hemi-pelvis. The current study constructed a series of FEA models of the same human pelvis to investigate the sensitivity of the predicted stress distributions to the type of boundary conditions applied, in particular to represent the sacro-iliac joint and pubic symphysis. Varying the method of modelling the sacro-iliac joint did not produce significant variations in the stress distribution, however changes to the modelling of the pubic symphysis were observed to have a greater effect on the results. Over-constraint of the symphysis prevented the bending of the pelvis about the greater sciatic notch, and underestimated high stresses within the ilium. However, permitting medio-lateral translation to mimic widening of the pelvis addressed this problem. These findings underline the importance of applying the appropriate boundary conditions to FEA models, and provide guidance on suitable methods of constraining the pelvis when, for example, scan data has not captured the full pelvic girdle. The results also suggest a valid method for performing hemi-pelvic modelling of cadaveric or archaeological remains which are either damaged or incomplete

Mechanical properties of calvarial bones in a mouse model for craniosynostosis

The mammalian cranial vault largely consists of five flat bones that are joined together along their edges by soft fibrous tissues called sutures. Premature closure of the cranial sutures, craniosynostosis, can lead to serious clinical pathology unless there is surgical intervention. Research into the genetic basis of the disease has led to the development of various animal models that display this condition, e.g. mutant type Fgfr2C342Y/+ mice which display early fusion of the coronal suture (joining the parietal and frontal bones). However, whether the biomechanical properties of the mutant and wild type bones are affected has not been investigated before. Therefore, nanoindentation was used to compare the elastic modulus of cranial bone and sutures in wild type (WT) and Fgfr2C342Y/+mutant type (MT) mice during their postnatal development. Further, the variations in properties with indentation position and plane were assessed. No difference was observed in the elastic modulus of parietal bone between the WT and MT mice at postnatal (P) day 10 and 20. However, the modulus of frontal bone in the MT group was lower than the WT group at both P10 (1.39±0.30 vs. 5.32±0.68 GPa; p<0.05) and P20 (5.57±0.33 vs. 7.14±0.79 GPa; p<0.05). A wide range of values was measured along the coronal sutures for both the WT and MT samples, with no significant difference between the two groups. Findings of this study suggest that the inherent mechanical properties of the frontal bone in the mutant mice were different to the wild type mice from the same genetic background. These differences may reflect variations in the degree of biomechanical adaptation during skull growth, which could have implications for the surgical management of craniosynostosis patients

Form-function relationships in dragonfly mandibles under an evolutionary perspective

© 2017 The Author(s). Functional requirements may constrain phenotypic diversification or foster it. For insect mouthparts, the quantification of the relationship between shape and function in an evolutionary framework remained largely unexplored. Here, the question of a functional influence on phenotypic diversification for dragonfly mandibles is assessed with a large-scale biomechanical analysis covering nearly all anisopteran families, using finite element analysis in combination with geometric morphometrics. A constraining effect of phylogeny could be found for shape, the mandibular mechanical advantage (MA), and certain mechanical joint parameters, while stresses and strains, the majority of joint parameters and size are influenced by shared ancestry. Furthermore, joint mechanics are correlated with neither strain nor mandibular MA and size effects have virtually play no role for shape or mechanical variation. The presence of mandibular strengthening ridges shows no phylogenetic signal except for one ridge peculiar to Libelluloidea, and ridge presence is also not correlated with each other. The results suggest that functional traits are more variable at this taxonomic level and that they are not influenced by shared ancestry. At the same time, the results contradict the widespread idea that mandibular morphology mainly reflects functional demands at least at this taxonomic level. The varying functional factors rather lead to the same mandibular performance as expressed by the MA, which suggests a many-to-one mapping of the investigated parameters onto the same narrow mandibular performance space

The biomechanical function of periodontal ligament fibres in orthodontic tooth movement

Orthodontic tooth movement occurs as a result of resorption and formation of the alveolar bone due to an applied load, but the stimulus responsible for triggering orthodontic tooth movement remains the subject of debate. It has been suggested that the periodontal ligament (PDL) plays a key role. However, the mechanical function of the PDL in orthodontic tooth movement is not well understood as most mechanical models of the PDL to date have ignored the fibrous structure of the PDL. In this study we use finite element (FE) analysis to investigate the strains in the alveolar bone due to occlusal and orthodontic loads when PDL is modelled as a fibrous structure as compared to modelling PDL as a layer of solid material. The results show that the tension-only nature of the fibres essentially suspends the tooth in the tooth socket and their inclusion in FE models makes a significant difference to both the magnitude and distribution of strains produced in the surrounding bone. The results indicate that the PDL fibres have a very important role in load transfer between the teeth and alveolar bone and should be considered in FE studies investigating the biomechanics of orthodontic tooth movement. © 2014 McCormack et al