Hossein Mokhtarzadeh

A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings.

The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies.

THE EFFECTS OF INTRA-ABDOMINAL PRESSURE ON THE STABILITY AND UNLOADING OF THE SPINE

In spite of earlier experimental and modeling studies, the relative role of the intra-abdominal pressure (IAP) in spine mechanics has remained controversial. This study employs simple analytical and finite element (FE) models of the spine and its surrounding structures to investigate the contribution of IAP to spinal loading and stability. The analytical model includes the abdominal cavity surrounded by muscles, lumbar spine, rib cage and pelvic ring. The intra-abdominal cavity and its surrounding muscles are represented by a thin deformable cylindrical membrane. Muscle activation levels are simulated by changing the Youngs modulus of the membrane in the direction of muscle fibers, yielding IAP values recorded under the partial Valsalva maneuver. In the FE model, the abdominal cavity is cylindrical and filled with a nearly incompressible fluid. The surrounding muscles are modeled as membrane elements with transverse isotropic material properties simulating their fiber orientation. Results indicate a good...

The Femoral Neck Mechanoresponse to Hip Extensors Exercise: A Case Study.

Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD) in the exercise leg were adjusted for changes in the control leg. The biomechanical stimulus for bone adaptation (BS) was calculated using published models of the musculoskeletal system and the average hip extension moment in elderly participants. Volumetric (ΔvBMD) and areal (ΔaBMD) BMD changes were calculated. The measured and calculated BMD changes consistently showed a positive and negative effect of exercise in the femoral neck (ΔaBMD = +0.7%; ΔvBMD = +0.8%) and the trochanter region (ΔaBMD = −4.1%; ΔvBMD = −0.5%), respectively. The 17% of the femoral neck exceeded the 75th percentile of the spatially heterogeneous BS distribution. Hip extensor exercises may be beneficial in the proximal femoral neck but not in the trochanteric region. DXA-based measurements may not capture significant aBMD local changes.

Restrained tibial rotation may prevent ACL injury during landing at different flexion angles

BACKGROUND Internal tibial rotation is a risk factor for anterior cruciate ligament (ACL) injury. The effect of restraining tibial rotation (RTR) to prevent ACL injury during single-leg landing is not well understood. We aimed to investigate the effect of impact load and RTR on ACL injury with respect to flexion angle. We hypothesized that RTR could protect the knee from ACL injury compared to free tibial rotation (FTR) regardless of flexion angle and create a safety zone to protect the ACL. METHODS Thirty porcine specimens were potted in a rig manufactured to replicate single-leg landing maneuvers. A mechanical testing machine was used to apply external forces in the direction of the tibial long axis. A 3D displacement sensor measured anterior tibial translation (ATT). The specimens were divided into 3 groups of 10 specimens and tested at flexion angles of 22 ± 1°, 37 ± 1° and 52 ± 1° (five RTR and five FTR) through a consecutive range of actuator displacements until ACL failure. After dissection, damage to the joint was visually recorded. Two-way ANOVA were utilized in order to compare compressive forces, torques and A/P displacements with respect to flexion angle. RESULTS The largest difference between peak axial compressive forces (~3.4 kN) causing ACL injury between RTR and FTR was reported at a flexion angle of 22°. Tibial torques with RTR was in the same range and < 20 Nm at the instance and just before ACL failure, compared to a significant reduction when cartilage/bone damage (no ACL failure) was reported. Isolated ACL injuries were observed in ten of the 15 FTR specimens. Injuries to bone and cartilage were more common with RTR. CONCLUSIONS RTR increases the threshold for ACL injury by elevating the compressive impact load required at lower flexion angles. These findings may contribute to neuromuscular training programs or brace designs used to avoid excessive internal/external tibial rotation. Caution must be exercised as bone/cartilage damage may result.

FINITE ELEMENT STUDY OF THE INTRACTION OF SPINE, IAP AND SURROUNDING MUSCLES

INTRODUCTION Low back pain is one of the most costly disorders that disturbs the productivity and well-being of affected population. The role and significance of the intra-abdominal pressure (IAP) in spine mechanics has remained controversial and only a few studies investigated the effects of IAP on spine stability. Hence, we developed an FE model in order to advance our previous model studies [1, 2]. The muscles are modeled as continuous fiber-reinforced membranes that surround the intra-abdominal cavity. These models also take advantage of beam elements representing the spine. Then an optimization program using APDL was performed to evaluate the muscles recruitment while considering IAP effect. Although our model is still idealized due to its anatomical details, it can predict IAP effect on the active spine.

The effect of leg dominance and landing height on ACL loading among female athletes

Female athletes are more prone to anterior cruciate ligament (ACL) injury. A neuromuscular imbalance called leg dominance may provide a biomechanical explanation. Therefore, the purpose of this study was to compare the side-to-side lower limb differences in movement patterns, muscle forces and ACL forces during a single-leg drop-landing task from two different heights. We hypothesized that there will be significant differences in lower limb movement patterns (kinematics), muscle forces and ACL loading between the dominant and non-dominant limbs. Further, we hypothesized that significant differences between limbs will be present when participants land from a greater drop-landing height. Eight recreational female participants performed dominant and non-dominant single-leg drop landings from 30 to 60cm. OpenSim software was used to develop participant-specific musculoskeletal models and to calculate muscle forces. We also predicted ACL loading using our previously established method. There were no significant differences between dominant and non-dominant leg landing except in ankle dorsiflexion and GMED muscle forces at peak GRF. Landing from a greater height resulted in significant differences among most kinetics and kinematics variables and ACL forces. Minimal differences in lower-limb muscle forces and ACL loading between the dominant and non-dominant legs during single-leg landing may suggest similar risk of injury across limbs in this cohort. Further research is required to confirm whether limb dominance may play an important role in the higher incidence of ACL injury in female athletes with larger and sport-specific cohorts.

Antagonist muscle co-contraction during a double-leg landing maneuver at two heights

Abstract Background: Knee injuries are common during landing activities. Greater landing height increases peak ground reaction forces (GRFs) and loading at the knee joint. As major muscles to stabilize the knee joint, Quadriceps and Hamstring muscles provide internal forces to attenuate the excessive GRF. Despite the number of investigations on the importance of muscle function during landing, the role of landing height on these muscles forces using modeling during landing is not fully investigated. Methods: Participant-specific musculoskeletal models were developed using experimental motion analysis data consisting of anatomic joint motions and GRF from eight male participants performing double-leg drop landing from 30 and 60 cm. Muscle forces were calculated in OpenSim and their differences were analyzed at the instances of high risk during landing i.e. peak GRF for both heights. Results: The maximum knee flexion angle and moments were found significantly higher from a double-leg landing at 60 cm compared to 30 cm. The results showed elevated GRF, and mean muscle forces during landing. At peak GRF, only quadriceps showed significantly greater forces at 60 cm. Hamstring muscle forces did not significantly change at 60 cm compared to 30 cm. Conclusions: Quadriceps and hamstring muscle forces changed at different heights. Since hamstring forces were similar in both landing heights, this could lead to an imbalance between the antagonist muscles, potentially placing the knee at risk of injury if combined with small flexion angles that was not observed at peak GRF in our study. Thus, enhanced neuromuscular training programs strengthening the hamstrings may be required to address this imbalance. These findings may contribute to enhance neuromuscular training programs to prevent knee injuries during landing.

Understanding Anterior Cruciate Ligament Injury Due to Drop Landing: Effects of Different Landing Techniques and Muscles’ Action at the Knee Joint

Jumping and subsequent landing was found to be one of the most injurious maneuvers to the anterior cruciate ligament (ACL). The ability to predict ACL susceptibility to injury is extremely difficult due to the complex interaction between the lower extremity joints and the surrounding musculoskeletal structure. While muscles play an important role, whether they act to prevent ACL injury during drop landing is still debatable. Our objective is to quantify and compare the muscles recruitment and actions for different drop landing methods, which include single and double leg landing. We hypothesized that: 1.) recruitment of antagonist muscles (Quadriceps force (Q) and Hamstrings force (H)) differs between the two different drop landing methods; 2.) a linear relationship exists between Q/H ratio and Ground Reaction Force (GRF), independent of drop landing height and landing methods. Lower extremity muscles’ force were calculated and compared. Vertical GRF was found to increase in single leg landing. GRF and Q/H ratio were inversely proportional at the time of peak GRF. We concluded that muscles’ force ratio around knee joint in conjunction with GRF and knee flexion angle are important parameters affecting the risk of ACL injury during drop landing.

Mathematical and Finite Element Modelling of Spine to Investigate the Effects of Intra-Abdominal Pressure and Activation of Muscles Around Abdomen on the Spinal Stability

In spite of the several experimental and modeling studies on the biomechanical characteristics of the human spine, the role and significance of the intra-abdominal pressure (IAP) in spine mechanics has remained controversial. This study represents a simple analytical and a 3-D finite element model of spine and its surrounding structures to investigate the contribution of IAP to spinal stability. The mathematical model included the lumbar spine column, the abdominal cavity and a muscular layer around it, the rib cage and the pelvic ring. The lumbar spine column was modeled as a beam and the rib cage and pelvis as rigid bodies. The intra-abdominal cavity and the surrounding muscular layer were represented by a thin-wall cylindrical vessel with deformable shell wall. The free body diagram and equilibrium equations of each body of the model were derived while an external load to the rib cage was applied. The equations were then combined with the force-deflection relationships for the beam bending, the IAP fluid volume variation, and the muscle shell traction. Muscle activation levels were simulated by changing the Young’s modulus of the shell in the direction of fibers, up to an upper-limit value which was obtained based on the Valsalva maneuver. In the Finite Element (FE) model, the abdominal cavity was assumed to be cylindrical and filled by fluid with a bulk modulus of IMPa. The surrounding muscular layer was modeled as membrane with transverse isotropic material properties considering their fibers orientation. The spine, rib cage and pelvic ring were modeled by beam elements. The top plate simulated the active and/or passive role of diaphragm through its vertical displacement. The bottom membrane and distal spine were fully constrained. Good agreement between the analytical and FE model results was obtained. A larger external force and/or higher level of muscle activation caused a higher IAP, improving spinal unloading and stability. This effect was more significant for muscles with more horizontally directed fibers, e.g., Transverse Abdominis (TA).Copyright