Michael J. Rainbow

Kinematic differences between optical motion capture and biplanar videoradiography during a jump-cut maneuver

Jumping and cutting activities are investigated in many laboratories attempting to better understand the biomechanics associated with non-contact ACL injury. Optical motion capture is widely used; however, it is subject to soft tissue artifact (STA). Biplanar videoradiography offers a unique approach to collecting skeletal motion without STA. The goal of this study was to compare how STA affects the six-degrees-of-freedom motion of the femur and tibia during a jump-cut maneuver associated with non-contact ACL injury. Ten volunteers performed a jump-cut maneuver while their landing leg was imaged using optical motion capture (OMC) and biplanar videoradiography. The within-bone motion differences were compared using anatomical coordinate systems for the femur and tibia, respectively. The knee joint kinematic measurements were compared during two periods: before and after ground contact. Over the entire activity, the within-bone motion differences between the two motion capture techniques were significantly lower for the tibia than the femur for two of the rotational axes (flexion/extension, internal/external) and the origin. The OMC and biplanar videoradiography knee joint kinematics were in best agreement before landing. Kinematic deviations between the two techniques increased significantly after contact. This study provides information on the kinematic discrepancies between OMC and biplanar videoradiography that can be used to optimize methods employing both technologies for studying dynamic in vivo knee kinematics and kinetics during a jump-cut maneuver.

Automatic determination of anatomical coordinate systems for three-dimensional bone models of the isolated human knee.

The combination of three-dimensional (3-D) models with dual fluoroscopy is increasingly popular for evaluating joint function in vivo. Applying these modalities to study knee motion with high accuracy requires reliable anatomical coordinate systems (ACSs) for the femur and tibia. Therefore, a robust method for creating ACSs from 3-D models of the femur and tibia is required. We present and evaluate an automated method for constructing ACSs for the distal femur and proximal tibia based solely on 3-D bone models. The algorithm requires no observer interactions and uses model cross-sectional area, center of mass, principal axes of inertia, and cylindrical surface fitting to construct the ACSs. The algorithm was applied to the femur and tibia of 10 (unpaired) human cadaveric knees. Due to the automated nature of the algorithm, the within specimen variability is zero for a given bone model. The algorithms repeatability was evaluated by calculating variability in ACS location and orientation across specimens. Differences in ACS location and orientation between specimens were low (<1.5mm and <2.5 degrees). Variability arose primarily from natural anatomical and morphological differences between specimens. The presented algorithm provides an alternative method for automatically determining subject-specific ACSs from the distal femur and proximal tibia.

Landing pattern and vertical loading rates during first attempt of barefoot running in habitual shod runners.

There is evidence supporting that habitual barefoot runners are able to disperse impact loading rates by landing pattern modification. Yet, case studies suggested that barefoot running may result in severe running injuries, such as metatarsal and calcaneal stress fractures. Injuries may be due to a difference in biomechanical response between habitual and novice barefoot runners. This study investigated the initial effects of barefoot running in habitual shod runners in terms of landing pattern modification and vertical loading rates. Thirty habitual shod runners (mean age 25.5±5.2years; 18 men; with a minimum running mileage of 30km per week for at least one year) ran on an instrumented treadmill at 10km/h shod and barefoot in a randomized order. Vertical average (VALR) and instantaneous loading rates (VILR) were obtained by established methods. Landing pattern was presented as a ratio between the number of footfalls with a heelstrike and the total step number. Twenty participants demonstrated an automatic transition to a non-heelstrike landing during barefoot running, whereas a mixed landing pattern was observed in 10 participants. Compared to shod running, both VALR and VILR were significantly reduced during barefoot running (p<.021). In the subgroup analysis, VALR for the shod condition was significantly higher than barefoot running, regardless of the landing pattern. VALR for the non-heelstrike pattern during barefoot running was significantly lower than participants with a mixed landing pattern. Conversely, we observed two participants who completely altered their landing patterns, presented high VALR and VILR values. Habitual shod runners presented lower loading rates during barefoot running but their landing pattern transitions were not uniform. Novice barefoot runners with a mixed landing pattern may sustain higher loading rates, compared with those who completely avoided heelstrike pattern. However, a complete landing pattern modification may not guarantee lower loading rates.

In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

BackgroundThe thumb carpometacarpal (CMC) joint is often affected by osteoarthritis—a mechanically mediated disease. Pathomechanics of the CMC joint, however, are not thoroughly understood due to a paucity of in vivo data.Questions/purposesWe documented normal, in vivo CMC joint kinematics during isometric functional tasks. We hypothesized there would be motion of the CMC joint during these tasks and that this motion would differ with sex and age group. We also sought to determine whether the rotations at the CMC joint were coupled and whether the trapezium moved with respect to the third metacarpal.MethodsForty-six asymptomatic subjects were CT-scanned in a neutral position and during three functional tasks (key pinch, jar grasp, jar twist), in an unloaded and a loaded position. Kinematics of the first metacarpal, third metacarpal, and the trapezium were then computed.ResultsSignificant motion was identified in the CMC joint during all tasks. Sex did not have an effect on CMC joint kinematics. Motion patterns differed with age group, but these differences were not systematic across the tasks. Rotation at the CMC joint was generally coupled and posture of the trapezium relative to the third metacarpal changed significantly with thumb position.ConclusionsThe healthy CMC joint is relatively stable during key pinch, jar grasp, and jar twist tasks, despite sex and age group.Clinical RelevanceOur findings indicate that directionally coupled motion patterns in the CMC joint, which lead to a specific loading profile, are similar in men and women. These patterns, in addition to other, nonkinematic influences, especially in the female population, may contribute to the pathomechanics of the osteoarthritic joint.

Implications of using hierarchical and six degree-of-freedom models for normal gait analyses

Hierarchical biomechanical models (conventional gait model, CGM) are attractive because of simple data collection demands, yet they are susceptible to errors that are theoretically better controlled using six degree-of-freedom models that track body segments independently (OPT1). We wished to compare gait variables obtained with these models. Twenty-five normal children walked while wearing a hybrid marker configuration, permitting identical strides to be analyzed using CGM and OPT1. Kinematics and ground reaction forces were obtained using a common motion capture system. CGM and OPT1 were implemented in Visual3D software, where inverse dynamics provided 20 clinically relevant gait variables (joint angles, moments and powers). These were compared between models using dependent t-tests (Bonferroni-adjusted alpha of 0.0025), and ensemble averages. We hypothesized that OPT1 would provide data similar to CGM in the sagittal plane, and different from CGM in coronal and transverse planes. Six variables were significantly different in the sagittal plane, suggesting that CGM produced a more extended lower extremity; this was explained by a posterior bias to the lateral knee marker during knee flexion, as a result of skin movement artifact. No significant differences were found in coronal plane variables. Four variables were significantly different in the transverse plane. Ensemble averages were comparable between models. For normal children, biomechanical interpretations based upon these tested variables are unlikely to change due to independent segment tracking alone (CGM vs. OPT1). Additional differences may appear due to pathology, and when segment reference frames are changed from those used in CGM to reflect individual anatomy.

In Vivo Kinematics of the Scaphoid, Lunate, Capitate, and Third Metacarpal in Extreme Wrist Flexion and Extension

PURPOSE Insights into the complexity of active in vivo carpal motion have recently been gained using 3-dimensional imaging; however, kinematics during extremes of motion has not been elucidated. The purpose of this study was to determine motion of the carpus during extremes of wrist flexion and extension. METHODS We obtained computed tomography scans of 12 healthy wrists in neutral grip, extreme loaded flexion, and extreme loaded extension. We obtained 3-dimensional bone surfaces and 6-degree-of-freedom kinematics for the radius and carpals. The flexion and extension rotation from neutral grip to extreme flexion and extreme extension of the scaphoid and lunate was expressed as a percentage of capitate flexion and extension and then compared with previous studies of active wrist flexion and extension. We also tested the hypothesis that the capitate and third metacarpal function as a single rigid body. Finally, we used joint space metrics at the radiocarpal and midcarpal joints to describe arthrokinematics. RESULTS In extreme flexion, the scaphoid and lunate flexed 70% and 46% of the amount the capitate flexed, respectively. In extreme extension, the scaphoid extended 74% and the lunate extended 42% of the amount the capitates extended, respectively. The third metacarpal extended 4° farther than the capitate in extreme extension. The joint contact area decreased at the radiocarpal joint during extreme flexion. The radioscaphoid joint contact center moved onto the radial styloid and volar ridge of the radius in extreme flexion from a more proximal and ulnar location in neutral. CONCLUSIONS The contributions of the scaphoid and lunate to capitate rotation were approximately 25% less in extreme extension compared with wrist motion through an active range of motion. More than half the motion of the carpus when the wrist was loaded in extension occurred at the midcarpal joint. CLINICAL RELEVANCE These findings highlight the difference in kinematics of the carpus at the extremes of wrist motion, which occur during activities and injuries, and give insight into the possible etiologies of the scaphoid fractures, interosseous ligament injuries, and carpometacarpal bossing.

Functional kinematics of the wrist

The purpose of this article is to review past and present concepts concerning functional kinematics of the healthy and injured wrist. To provide a context for students of the wrist, we describe the progression of techniques for measuring carpal kinematics over the past century and discuss how this has influenced today’s understanding of functional kinematics. Next, we provide an overview of recent developments and highlight the clinical relevance of these findings. We use these findings and recent evidence that supports the importance of coupled motion in early rehabilitation of radiocarpal injuries to develop the argument that coupled motion during functional activities is a clinically relevant outcome; therefore, clinicians should develop a framework for its dynamic assessment. This should enable a tailored and individualized approach to the treatment of carpal injuries.

Effects of Surface Inclination on the Vertical Loading Rates and Landing Pattern during the First Attempt of Barefoot Running in Habitual Shod Runners.

Barefoot running has been proposed to reduce vertical loading rates, which is a risk factor of running injuries. Most of the previous studies evaluated runners on level surfaces. This study examined the effect of surface inclination on vertical loading rates and landing pattern during the first attempt of barefoot running among habitual shod runners. Twenty habitual shod runners were asked to run on treadmill at 8.0 km/h at three inclination angles (0°; +10°; −10°) with and without their usual running shoes. Vertical average rate (VALR) and instantaneous loading rate (VILR) were obtained by established methods. Landing pattern was decided using high-speed camera. VALR and VILR in shod condition were significantly higher (p < 0.001) in declined than in level or inclined treadmill running, but not in barefoot condition (p > 0.382). There was no difference (p > 0.413) in the landing pattern among all surface inclinations. Only one runner demonstrated complete transition to non-heel strike landing in all slope conditions. Reducing heel strike ratio in barefoot running did not ensure a decrease in loading rates (p > 0.15). Conversely, non-heel strike landing, regardless of footwear condition, would result in a softer landing (p < 0.011).

A thumb carpometacarpal joint coordinate system based on articular surface geometry

The thumb carpometacarpal (CMC) joint is a saddle-shaped articulation whose in vivo kinematics can be explored more accurately with computed tomography (CT) imaging methods than with previously used skin-based marker systems. These CT-based methods permit a detailed analysis of the morphology of the joint, and thus the prominent saddle geometry can be used to define a coordinate system that is inherently aligned with the primary directions of motion at the joint. The purpose of this study was to develop a CMC joint coordinate systems that is based on the computed principal directions of curvature on the trapezium and the first metacarpal. We evaluated the new coordinate system using bone surface models segmented from the CT scans of 24 healthy subjects. An analysis of sensitivity to the manual selection of articular surfaces resulted in mean orientation differences of 0.7±0.7° and mean location differences of 0.2±0.1mm. Inter-subject variability, which mostly emanates from anatomical differences, was evaluated with whole bone registration and resulted in mean orientation differences of 3.1±2.7° and mean location differences of 0.9±0.5mm. The proposed joint coordinate system addresses concerns of repeatability associated with bony landmark identification and provides a robust platform for describing the complex kinematics of the CMC joint.

In Vivo Triquetrum-Hamate Kinematics Through a Simulated Hammering Task Wrist Motion

BACKGROUND The shape and kinematics of the triquetrum-hamate joint have been the subject of continued research, as its articulation provides wrist stability and motion. The purpose of this study was to measure the in vivo articulation of the triquetrum-hamate joint as the wrist moves along an important functional wrist motion, the dart throwers path. METHODS The right wrist of six male and six female volunteers (average age [and standard deviation], 24.8 ± 3.8 years) were imaged with computed tomography in five positions along a simulated hammering task. Three-dimensional kinematics of the third metacarpal, triquetrum, hamate, and radius were analyzed with use of the rotation axis and the path of contact areas. RESULTS As the wrist ulnar-flexed with respect to the radius, the triquetrum translated 3.7 ± 1.7 mm distally on the hamate. Approximately midway through this distal course, when the triquetrum appeared to engage the distal ridge of the hamate, the triquetrum began translating volarly. Total volar translation was 2.6 ± 1.1 mm. As the wrist ulnar-flexed, there was also a decrease in the distance and variability in the location of the triquetrum-hamate rotation axis from the hamate centroid: it decreased from 11.7 ± 4.1 mm to 3.3 ± 1.4 mm (p < 0.0001). CONCLUSIONS Our findings support the concept that the triquetrum rotates on the convex ellipsoid surface of the hamate and that the helicoidal description of the triquetrums motion on the hamate may be an oversimplification.