Sharif Digital Repository

Knee osteoarthritis (KOA) is a common musculoskeletal disorder resulting in altered gait patterns. Uncontrolled manifold (UCM) analysis has been demonstrated as a useful approach for quantitative analysis of motor variability and synergies. The present study aimed to investigate the changes in the kinematic synergy, controlling the center of mass (COM) position while walking on normal and narrow paths in people with KOA compared to asymptomatic participants. In this cross-sectional study, twenty people with mild to moderate KOA and twenty asymptomatic individuals walked at their comfortable preferred speed across normal and narrow paths on a treadmill. The UCM analysis was performed... 

Background: Females are two times more likely to develop patellofemoral pain (PFP) than males. Abnormal trunk and pelvis kinematics are thought to contribute to the pathomechanics of this condition. However, there is a scarcity of evidence investigating proximal segments kinematics in females with PFP. Research question: The purpose of this study was to investigate whether females with PFP demonstrate altered trunk, pelvis, and knee joint kinematics compared with healthy controls during running. Methods: Thirty-four females (17 PFP, 17 controls) underwent a 3-dimensional motion analysis during treadmill running at preferred and fixed speeds, each trial for 30 s. Variables of interest... 

The purpose of this work is to develop a computational model to describe the task of sit to stand (STS). STS is an important movement skill which is frequently performed in human daily activities, but has rarely been studied from the perspective of optimization principles. In this study, we compared the recorded trajectories of STS with the trajectories generated by several conventional optimization-based models (i.e., minimum torque, minimum torque change and kinetic energy cost models) and also with the trajectories produced by a novel multi-phase cost model (MPCM). In the MPCM, we suggested that any complex task, such as STS, is decomposable into successive motion phases, so that each... 

Evaluation of spinal range of motions (RoMs) and movement coordination between its segments (thorax, lumbar, and pelvis) has clinical and biomechanical implications. Previous studies have not recorded three-dimensional primary/coupled motions of all spinal segments simultaneously. Moreover, magnitude/direction of the coupled motions of the thorax/pelvis in standing posture and lumbopelvic rhythms in the frontal/transverse planes have not been investigated. This study, hence, used an inertial tracking device to measure T1, T5, T12, total (T1-T12) thoracic, lower (T5-T12) and upper (T1-T5) thoracic, lumbar (T12-S1), and pelvis primary and coupled RoMs as well as their movement coordination in... 

Objectives: The purpose of this paper is to describe the development and evaluation of a new medial linkage reciprocating gait orthosis (MLRGO) that incorporates a reciprocal mechanism and is sensitive to pelvic motion to potentially assist paraplegic patients to walk and provide functional independence. Case description and methods: The new orthosis was constructed and tested by a 20-year-old female paraplegic subject with transverse myelitis at T10 level, who was 4 years post injury and had also been an isocentric reciprocating gait orthosis (IRGO) user for 2 years. She received gait training for 12 weeks before undertaking gait analysis, and also completed a questionnaire that was... 

Background: The use of knee-ankle-foot orthoses with drop locked knee joints produces some limitations for walking in subjects with quadriceps muscle weakness. The development of stance control orthoses can potentially improve their functionality. Objectives: The aim of this review was to compare the evidence of the effect of stance control orthoses to knee-ankle-foot orthoses with drop locked knee joints in improving kinematic variables and energy efficiency of walking by subjects with quadriceps muscle weakness caused by different pathologies. Study design: Literature review. Methods: Based on selected keywords and their composition, a search was performed in Google Scholar, PubMed,... 

The effect of the variation in the femoral groove geometry on patellofemoral joint stability was studied using a two dimensional transverse plane model with deformable articular surfaces. The femoral and patellar bony structures were modelled as rigid bodies with their profiles expressed by splines. The articular cartilage was discretized into compression springs, distributed along the femoral and patellar profiles, based on the rigid-body spring model. The medial and lateral retinacula were modelled as linear tensile springs, and the quadriceps muscles and patellar tendon as strings with known tension. The anatomical data were obtained from the transverse plane magnetic resonance images of... 

Background: Functional knee braces are extensively used for partially and completely torn anterior cruciate ligament (ACL) patients and those who have undergone ACL graft reconstruction, in order to support the healing ACL, improve the joint's functional stability, and restore the normal joint kinematics. Research question: Does wearing braces alter the arthrokinematics of the ACL deficient knees during lung exercise? Methods: For ten male unilateral ACL deficient subjects, 3D knee models were reconstructed from CT images, acquired in rest position. Sagittal plane fluoroscopy was then performed throughout a complete cycle of lunge in braced and non-braced conditions. The 3D kinematics of the... 

Purpose: This study aimed to investigate the biomechanical impact of laminectomy on cervical intersegmental motion and load sharing using a parametric patient-specific finite element (FE) model towards providing clinicians with a viable quantitative tool for informed decision-making and improved surgical planning. Methods: Ten subject-specific nonlinear osteo-ligamentous cervical spine (C3–C7) FE models were developed using X-ray image-based algorithms. The models were used to evaluate the effect of laminectomy on lower cervical spine biomechanics for two-level (C3–C4) and three-level (C3–C5) laminectomy procedures. Results: The average cervical spine ranges of motion (ROM) for the pre-op... 

Objective: The purpose of this study was to compare the relative stiffness of four common external fixation (XF) configurations used to span and stabilize the knee after knee dislocation. Methods: Synthetic composite femora and tibiae connected with cords were used to simulate a knee. Four configurations of external fixation were tested: anterior femoral pins with monotube (XF1), anterolateral femoral pins with monotube (XF2), anterolateral femoral pins with two connecting rods (XF3), and hinged ring fixator (XF4). Six specimens of each configuration were loaded nondestructively in varus/valgus, anterior-to- posterior shear, flexion/extension, axial compression, internal/external torsion,... 

Measurements of spinal segment ranges of motion (RoMs), movement coordination, and three-dimensional kinematics during occupational activities have implications in occupational/clinical biomechanics. Due to the large amount of adipose tissues, obese individuals may have different RoMs, lumbopelvic coordination, and kinematics than normal-weight ones. We aimed to measure/compare trunk, lumbar, and pelvis primary RoMs in all anatomical planes/directions, lumbopelvic ratios (lumbar to pelvis rotations at different trunk angles) in all anatomical planes/directions and three-dimensional spine kinematics during twelve symmetric/asymmetric statics load-handling activities in healthy normal-weight... 

Previous studies have measured thoracic Range of Motion (RoM) using either skin-mounted devices or supine CT-imaging and have reported on quite different RoMs. Given the inherent shortcomings of measurements of vertebrae movements from the overlying skin, the present study aims to measure normal RoM of the thoracic spine in the sagittal plane using the upright digital radiography. Lateral radiographs of the thoracic spine were obtained from eight asymptomatic male subjects in upright standing and full forward flexion using a mobile U-arm digital radiographic system. Total (T1-T12), upper (T1-T6), and lower (T6-T12) thoracic RoMs were measured. A throughout comparison of available skin-based... 

Previous studies have measured thoracic Range of Motion (RoM) using either skin-mounted devices or supine CT-imaging and have reported on quite different RoMs. Given the inherent shortcomings of measurements of vertebrae movements from the overlying skin, the present study aims to measure normal RoM of the thoracic spine in the sagittal plane using the upright digital radiography. Lateral radiographs of the thoracic spine were obtained from eight asymptomatic male subjects in upright standing and full forward flexion using a mobile U-arm digital radiographic system. Total (T1-T12), upper (T1-T6), and lower (T6-T12) thoracic RoMs were measured. A throughout comparison of available skin-based... 

Range of motion (ROM) of the thoracic spine has implications in patient discrimination for diagnostic purposes and in biomechanical models for predictions of spinal loads. Few previous studies have reported quite different thoracic ROMs. Total (T1-T12), lower (T5-T12) and upper (T1-T5) thoracic, lumbar (T12-S1), pelvis, and entire trunk (T1) ROMs were measured using an inertial tracking device as asymptomatic subjects flexed forward from their neutral upright position to full forward flexion. Correlations between body height and the ROMs were conducted. An effect of measurement errors of the trunk flexion (T1) on the model-predicted spinal loads was investigated. Mean of peak voluntary total... 

Background and Purpose: Understanding the role and significance of trunk and upper extremity muscles in paraplegic gait can help in designing more effective assistive devices for these patients and also provides valuable information for improving muscle strengthening programs. Methods: In a patient with a spinal cord injury (SCI) who could walk independently (rating scale of ambulatory capacity, 9) with the aid of bilateral ankle-foot orthosis and a walker, the kinematics, kinetics and electromyographic (EMG) activities of 16 muscles from the trunk and upper and lower extremities were recorded during gait. The onset, cessation, and duration of the EMG signal were associated with the 4 phases... 

A safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT) of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference... 

Passive finite element (FE) models of the spine are commonly used to simulate intact and various pre- and postoperative pathological conditions. Being devoid of muscles, these traditional models are driven by simplistic loading scenarios, e.g., a constant moment and compressive follower load (FL) that do not properly mimic the complex in vivo loading condition under muscle exertions. We aim to develop novel passive FE models that are driven by more realistic yet simple loading scenarios, i.e., in vivo vertebral rotations and pathological-condition dependent FLs (estimated based on detailed musculoskeletal finite element (MS-FE) models). In these novel force–displacement control FE models,... 

The dummies currently used for predicting vehicle occupant response during frontal crashes or whole-body vibration provide insufficient information about spinal loads. Although they aptly approximate upper-body rotations in different loading scenarios, they overlook spinal loads, which are crucial to injury assessment. This paper aims to develop a modified dummy finite element (FE) model with a detailed viscoelastic lumbar spine. This model has been developed and validated against in-vitro and in-silico data under different loading conditions, and its predicted ranges of motion (RoM) and intradiscal pressure (IDP) maintain close correspondence with the in-vitro data. The dominant frequency... 

Background: The purpose of this study was to propose a methodology for mechanical characterization of the ligaments in subject-specific models of the patellofemoral joint (PFJ) of living individuals. Method: PFJ laxity tests were performed on a healthy volunteer using a specially designed loading apparatus under biplane fluoroscopy. A three-dimensional (3D) parametric model of the PFJ was developed in the framework of the rigid body spring model using the geometrical data acquired from the subject's computed tomography and magnetic resonance images. The stiffness and pre-strains of the medial and lateral PFJ ligaments were characterized using a two-step optimization procedure which minimized... 

Background The ratio of total lumbar rotation over pelvic rotation (lumbopelvic rhythm) during trunk sagittal movement is essential to evaluate spinal loads and discriminate between low back pain and asymptomatic population. Methods Angular rotations of the pelvis and lumbar spine as well as their sagittal rhythm during forward flexion and backward extension in upright standing of eight asymptomatic males are measured using an inertial tracking device. The effect of variations in the lumbopelvic ratio during trunk flexion on spinal loads is quantified using a detailed musculoskeletal model. Findings The mean of peak voluntary flexion rotations of the thorax, pelvis, and lumbar was 121 (SD...