-Kung Cheng

Stress analysis of the disc adjacent to interbody fusion in lumbar spine

After anterior interbody fusion in the lumbar spine, the accelerated degeneration of the disc adjacent to the fusion levels was clinically observed. To understand the stress distribution of the adjacent disc, this study created a finite element model of the lumbar spine from L1-L5 vertebral body. The fusion model modified from the intact model was used to simulate the anterior interbody fusion. Various loading conditions, which included flexion, extension, lateral bending, and torsion, were applied to the finite element model to study the corresponding stress distribution. From the finite element model calculation, at a lower fusion site or more fusion levels, the stress of the disc adjacent to interbody fusion increased more than upper fusion site or single fusion level under flexion, torsion and lateral bending. Larger stress increase was estimated at the upper disc adjacent to interbody fusion than the lower disc adjacent to interbody fusion. In stress distribution, the upper disc adjacent to interbody fusion had a little alteration under torsion.

The effect of malalignment on stresses in polyethylene component of total knee prostheses – a finite element analysis

OBJECTIVE To investigate the effects of malalignment on stresses in tibial polyethylene component of total knee prostheses. DESIGN A three-dimensional finite element analysis was used to calculate the contact stress and von Mises stress in the tibial polyethylene component subjected to a compressive load, and the malalignment situations were simulated. BACKGROUND Many biomechanical studies to investigate the stresses in tibial polyethylene component were assumed at the ideal contact alignment. The effect of malalignment on stresses in tibial polyethylene component was not investigated extensively. METHODS Three-dimensional finite element models of the tibiofemoral joint of knee prostheses for three different designs were constructed. Three malalignment conditions including the medial translation (0.25, 0.5 and 1.0 mm), internal rotation (1 degree, 3 degree and 5 degree), and varus tilt (1 degree, 3 degree and 5 degree) of the femoral component relative to the tibial component were simulated. A compression load of 3000 N was applied to the tibiofemoral joint at 0 degree of flexion. The maximum contact stress and von Mises stress in the tibial component were compared to investigate the effects of malalignment. RESULTS In comparing with the neutral position, the greatest increase of maximum contact stress were 67.6%, 14.3% and 145.9% and the greatest increase of maximum von Mises stress were 92.5%, 22.7% and 120.6% in maltranslation, internal rotation and varus tilt simulations, respectively. CONCLUSION The greatest increase of contact stress and von Mises stress was occurred in the high conformity flat-on-flat design of knee prosthesis under the severest malalignment condition. The high conformity curve-on-curve design of knee prosthesis has the minimal risk of polyethylene wear under the malalignment conditions. RELEVANCE This study revealed the importance of malalignment effect on stresses in tibial polyethylene component. Polyethylene wear in surface replacement total knees will be minimal when a high conformity curve-on-curve knee design is used and the rotational line between the femoral and tibial components has the least effect on polyethylene wear but varus/valgus malalignment, even with the best designed prosthesis will still accelerate wear.

Segment inertial properties of Chinese adults determined from magnetic resonance imaging

OBJECTIVE To improve the simulation of the task of manual materials handling for Chinese laborers, this study estimated the inertial properties of Chinese adults by using magnetic resonance imaging. DESIGN Magnetic resonance imaging was used as a means of estimating inertial property. Following the estimation of inertial properties for the Chinese subjects, comparison between estimates for Chinese and Caucasian populations was made. BACKGROUND Estimates of segment inertial properties are frequently based on data and procedures developed from human cadaver studies in which inertial properties have been measured directly. The errors might be derived from the utilization of the Caucasian data were questioned in our previous study on the spinal force prediction of the Chinese subjects during manual lifting. METHODS Magnetic resonance images were scanned at a 20 mm interval from eight males aged 26 (S.D., 4) years. Tissues were differentiated and verified using adequate intensity thresholds on each slice, and the segmental volume and mass were integrated by slices. The moments of inertia for each segment were then determined about the anatomical axes using the parallel axis theorem.Results. Results showed that our estimates were close to the data derived by Dempster with a slight deviation. Larger percentages of mass were found in the upper arm (4.0%) and thigh (13.6%) than in previous studies. On the other hand, smaller moments of inertia about three axes were noted in the shank. CONCLUSION Biomechanical modeling of the human body requires accurate prediction of body segment parameters that include measures of volume, mass, center of mass, and moments of inertia. This study suggests the need to estimate the inertial properties of segments from the Chinese population. Application of the data may improve the simulation of the task of manual materials handling for Chinese laborers in the future studies. RELEVANCE Biomechanical modeling of the human body requires accurate prediction of body segment parameters that include measures of volume, mass, center of mass, and moments of inertia. To obtain the basic data of segment parameters for the Chinese adults, this study was proceeded with the magnetic resonance imaging technique.

Tumor cell cycle arrest induced by shear stress: Roles of integrins and Smad

Interstitial flow in and around tumor tissue affects the mechanical microenvironment to modulate tumor cell growth and metastasis. We investigated the roles of flow-induced shear stress in modulating cell cycle distribution in four tumor cell lines and the underlying mechanisms. In all four cell lines, incubation under static conditions for 24 or 48 h led to G0/G1 arrest; in contrast, shear stress (12 dynes/cm2) induced G2/M arrest. The molecular basis of the shear effect was analyzed, and the presentation on molecular mechanism is focused on human MG63 osteosarcoma cells. Shear stress induced increased expressions of cyclin B1 and p21CIP1 and decreased expressions of cyclins A, D1, and E, cyclin-dependent protein kinases (Cdk)-1, -2, -4, and -6, and p27KIP1 as well as a decrease in Cdk1 activity. Using specific antibodies and small interfering RNA, we found that the shear-induced G2/M arrest and corresponding changes in G2/M regulatory protein expression and activity were mediated by αvβ3 and β1 integrins through bone morphogenetic protein receptor type IA-specific Smad1 and Smad5. Shear stress also down-regulated runt-related transcription factor 2 (Runx2) binding activity and osteocalcin and alkaline phosphatase expressions in MG63 cells; these responses were mediated by αvβ3 and β1 integrins through Smad5. Our findings provide insights into the mechanism by which shear stress induces G2/M arrest in tumor cells and inhibits cell differentiation and demonstrate the importance of mechanical microenvironment in modulating molecular signaling, gene expression, cell cycle, and functions in tumor cells.

Evaluation of shoulder proprioception following muscle fatigue

OBJECTIVE To investigate the effect of shoulder muscle fatigue on glenohumeral proprioception. DESIGN A repeated proprioception test was performed. BACKGROUND The role of conditioning and fatigue in sport injuries remains controversial. It has been hypothesized that proprioceptive information plays an important role in joint stabilization and that muscle fatigue may alter proprioceptive ability. However, the effect of shoulder muscle fatigue on glenohumeral proprioception is still controversial. METHODS Eleven normal subjects (mean age 27.3 years) participated in this study. Proprioception tests (on the dominant shoulder) were performed in which proprioception of the active reproduced and passive reproduced shoulder position was measured using an isokinetic dynamometer and a proprioception testing apparatus, respectively. The speed of active repositioning was at 2 deg/s and passive repositioning was at 0.5 deg/s. The mean value of maximum voluntary contraction and the number of repetitions for muscle fatigue were recorded. Post-fatigue proprioception test was started within 3 min after muscle fatigue. RESULTS There was no significant difference of shoulder proprioception between pre- and post-fatigue determinations of passive repositioning in shoulder internal rotation, passive repositioning in external rotation and active repositioning in internal rotation. There was a significant difference between pre- and post-fatigue determination of active repositioning in external shoulder rotation (mean degrees: 2.57 (SD 1.02) vs. 4.96 (SD 1.73), P<0.05). CONCLUSION Shoulder proprioception in active repositioning in external rotation was major affected by muscle mechanoreceptors in the presence of muscle fatigue. RELEVANCE This study revealed that the shoulder proprioception after muscle fatigue in active repositioning in shoulder external rotation was affected more sensitively by the muscle mechanoreceptors than the joint mechanoreceptors. Increasing resistance of muscle fatigue would increase the shoulder proprioceptive ability.

A neuro-control system for the knee joint position control with quadriceps stimulation

A neuro-control system was designed to control the knee joint to move in accordance with the desired trajectory of movement through stimulation of quadriceps muscle. This control system consisted of a neural controller and a fixed parameter proportional-integral-derivative (PID) feedback controller, which was designated as a neuro-PID controller. A multilayer feedforward time-delay neural network was used and trained as an inverse model of the functional electrical stimulation (FES)-induced quadriceps-lower leg system for direct feedforward control. The training signals for neural network learning were obtained from experimentation using a low-pass filtered random sequence to reveal the plant characteristics. The Nguyen-Widrow method was used to initialize the neural connection weights. The conjugate gradient descent algorithm was then used to modify these connection weights so as to minimize the errors between the desired outputs and the network outputs. The knee joint angle was controlled with only small deviations along the desired trajectory with the aid of the neural controller. In addition, the PID feedback controller was utilized to compensate for the residual tracking errors caused by disturbances and modeling errors. This control strategy was evaluated on one able-bodied and one paraplegic subject. The neuro-PID controller showed promise as a position controller of knee joint angle with quadriceps stimulation.

The application of cepstral coefficients and maximum likelihood method in EMG pattern recognition [movements classification]

A new technique for classifying patterns of movement via electromyographic (EMG) signals is presented. Two methods (conventional autoregressive (AR) coefficients and cepstral coefficients) for extracting features from EMG signals and three classification algorithms (Euclidean Distance Measure (EDM), Weighted Distance Measure (WDM), and Maximum Likelihood Method (MLM)) for discriminating signals representative of broad classes of movements are described and compared. These three classifiers are derived from Bayes classifier with some assumptions, the relationship among them is discussed. The conventional MLM is modified to avoid heavy matrix inversion. Six able-bodied subjects with two pairs of surface electrodes located on bilateral sternocleidomastoid and upper trapezius muscles were studied in the experiment. The EMG signals of 20 repetitions of 10 motions were analyzed for each subject. Experimental results showed that mean recognition rate of the cepstral coefficients was at least 5% superior to that of the AR coefficients. The improvement achieved by the cepstral method was statistically significant for all the three classifiers. Reasons for the superiority of cepstral features were investigated from the feature space and frequency domain, respectively. The cepstral coefficients owned better cluster separability in feature space and they emphasized the more informative part in the frequency domain. The discrimination rate of the MLM was the highest among three classifiers. Incorporation of the cepstral features with the MLM could reduce the misclassification rate by 10.6% when compared with the combination of AR coefficients and EDM. Proper choice of five of ten motions could further raise the recognition rate to more than 95%.

Isokinetic elbow joint torques estimation from surface EMG and joint kinematic data: using an artificial neural network model

Because the relations between electromyographic signal (EMG) and anisometric joint torque remain unpredictable, the aim of this study was to determine the relations between the EMG activity and the isokinetic elbow joint torque via an artificial neural network (ANN) model. This 3-layer feed-forward network was constructed using an error back-propagation algorithm with an adaptive learning rate. The experimental validation was achieved by rectified, low-pass filtered EMG signals from the representative muscles, joint angle and joint angular velocity and measured torque. Learning with a limited set of examples allowed accurate prediction of isokinetic joint torque from novel EMG activities, joint position, joint angular velocity. Sensitivity analysis of the hidden node numbers during the learning and testing phases demonstrated that the choice of numbers of hidden node was not critical except at extreme values of those parameters. Model predictions were well correlated with the experimental data (the mean root-mean-square-difference and correlation coefficient gamma in learning were 0.0290 and 0.998, respectively, and in three different speed testings were 0.1413 and 0.900, respectively). These results suggested that an ANN model can represent the relations between EMG and joint torque/moment in human isokinetic movements. The effect of different adjacent electrode sites was also evaluated and showed the location of electrodes was very important to produce errors in the ANN model.

Real-time implementation of electromyogram pattern recognition as a control command of man-machine interface

The purpose of this study was to develop a real-time electromyogram (EMG) discrimination system to provide control commands for man-machine interface applications. A host computer with a plug-in data acquisition and processing board containing a TMS320 C31 floating-point digital signal processor was used to attain real-time EMG classification. Two-channel EMG signals were collected by two pairs of surface electrodes located bilaterally between the sternocleidomastoid and the upper trapezius. Five motions of the neck and shoulders were discriminated for each subject. The zero-crossing rate was employed to detect the onset of muscle contraction. The cepstral coefficients, derived from autoregressive coefficients and estimated by a recursive least square algorithm, were used as the recognition features. These features were then discriminated using a modified maximum likelihood distance classifier. The total response time of this EMG discrimination system was achieved about within 0.17 s. Four able bodied and two C5/6 quadriplegic subjects took part in the experiment, and achieved 95% mean recognition rate in discrimination between the five specific motions. The response time and the reliability of recognition indicate that this system has the potential to discriminate body motions for man-machine interface applications.

Contact areas and pressure distributions in the subtalar joint.

We investigated how foot position and ankle arthrodesis affect the contact characteristics of the subtalar joint. Nine fresh-frozen specimens of amputated lower legs were used. Pressure-sensitive films were inserted into the anterior and posterior articulation of the subtalar joint. The contact areas and pressure for various foot positions and under axial loads of 600, 1200, and 1800 N were determined based on the gray level of the digitized film. In neutral position and under a 600 N load, the maximum contact pressure in the subtalar joint was 5.13 +/- 1.16 MPa. The contact area (1.18 +/- 0.35 cm2) was only 12.7% of the whole subtalar articulation area (9.31 +/- 0.66 cm2), and the total force (348.5 +/- 41.7 N) transmitted via this contact area was about 58% of the applied load (600 N). Dorsiflexion of the foot increased the contact area and the force transmitted, but decreased the average contact pressure in the subtalar joint, while the reverse occurred in plantar flexion. Eversion increased the subtalar contact stress, whereas inversion up to 10 degrees decreased it. Ankle joint arthrodesis shifted the contact areas in the subtalar joint posteriorly in all inversion/eversion positions. Moreover, total force transmitted through the subtalar joint as well as the contact pressure increased.