Biomechanical Model Research Articles

Comparative analysis of novel esophageal pressure monitoring catheters versus commercially available alternatives in a biomechanical model of the thoracic cavity

Transpulmonary pressure can be estimated using esophageal balloon (EB) catheters, which come in a variety of manufacturing configurations. We assessed the performance of novel polyurethane EB designs, Aspisafe NG and NG+, against existing alternatives. We created a biomechanical model of the chest cavity using a plastic chamber and an ex-vivo porcine esophagus. The chamber was pressurized (− 20 and + 20 cmH2O) to simulate pleural pressures. We conducted tests with various EB inflation volumes and measured transesophageal pressure (TEP). TEP measurement was defined as accurate when the difference between pressure within the EB and chamber was 0 ± 1 cmH2O. We computed the minimal (Vaccuracy-min) and maximal (Vaccuracy-max) EB inflation volumes of accuracy. Inflation volumes were further validated using a surrogate method derived by the clinically validated positive pressure occlusion test (PPOT). When the esophageal balloons were filled with inflation volumes within the range provided by the manufacturers, the accuracy of TEP measurements was marginal. Our tests found median Vaccuracy-min across EB of 0.00–0.50 mL (p = 0.130), whereas Vaccuracy-max ranged 0.50–2.25 mL (p = 0.002). Post PPOT validation, median TEP was − 0.4 cmH2O (− 1.5 to 0.3) (p < 0.001 among catheters). The Aspisafe NG and NG+ were accurate in 81.7% and 77.8% of the measurements, respectively. We characterized two new EBs, which demonstrated good benchtop accuracy in TEP measurements. However, accuracy was notably influenced by the precise selection of EB inflation volumes.

A Critical Review of Human Jaw Biomechanical Modeling

The human jaw is a complex biomechanical system involving different anatomical components and an articulated muscular system devoted to its dynamical activation. The numerous actions exerted by the mandible, such as talking, eating or chewing, make its biomechanical comprehension absolutely indispensable. To date, even if research on this topic has achieved interesting outcomes using in vitro testing, thanks to the development of new apparatus and methods capable of performing more and more realistic experiments, theoretical modeling is still worthy of investigation. In light of this, nowadays, the Finite Element Method (FEM) approach constitutes certainly the most common tool adopted to investigate particular issues concerning stress–strain characterization of the human jaw. In addition, kinematics analyses, both direct and inverse, are also diffuse and reported in the literature. This manuscript aimed to propose a critical review of the most recurrent biomechanical models of the human mandible to give readers a comprehensive overview on the topic. In light of this, the numerical approaches, providing interesting outcomes, such as muscular activation profiles, condylar forces and stress–strain fields for the human oral cavity, are mainly differentiated between according to the joint degrees of freedom, the analytical descriptions of the muscular forces, the boundary conditions imposed, the kind of task and mandible anatomical structure modeling.

Interdependence of placenta and fetal cardiac development.

The placenta and fetal heart undergo development concurrently during early pregnancy, and, while human studies have reported associations between placental abnormalities and congenital heart disease (CHD), the nature of this relationship remains incompletely understood. Evidence from animal studies suggests a plausible cause and effect connection between placental abnormalities and fetal CHD. Biomechanical models demonstrate the influence of mechanical forces on cardiac development, whereas genetic models highlight the role of confined placental mutations that can cause some forms of CHD. Similar definitive studies in humans are lacking; however, placental pathologies such as maternal and fetal vascular malperfusion and chronic deciduitis are frequently observed in pregnancies complicated by CHD. Moreover, maternal conditions such as diabetes and pre-eclampsia, which affect placental function, are associated with increased risk of CHD in offspring. Bridging the gap between animal models and human studies is crucial to understanding how placental abnormalities may contribute to human fetal CHD. The next steps will require new methodologies and multidisciplinary approaches combining innovative imaging modalities, comprehensive genomic testing, and histopathology. These studies may eventually lead to preventative strategies for some forms of CHD by targeting placental influences on fetal heart development.

Validation of a computational biomechanical mouse brain model for rotational head acceleration.

Recent mouse brain injury experiments examine diffuse axonal injury resulting from accelerative head rotations. Evaluating brain deformation during these events would provide valuable information on tissue level thresholds for brain injury, but there are many challenges to imaging the brain's mechanical response during dynamic loading events, such as a blunt head impact. To address this shortcoming, we present an experimentally validated computational biomechanics model of the mouse brain that predicts tissue deformation, given the motion of the mouse head during laboratory experiments. First, we developed a finite element model of the mouse brain that computes tissue strains, given the same head rotations as previously conducted in situ hemicephalic mouse brain experiments. Second, we calibrated the model using a single brain segment, and then validated the model based on the spatial and temporal strain responses of other regions. The result is a computational tool that will provide researchers with the ability to predict brain tissue strains that occur during mouse laboratory experiments, and to link the experiments to the resulting neuropathology, such as diffuse axonal injury.

Gait Compensation among Children with Non-Operative Legg-Calvé-Perthes Disease: A Systematic Review.

A systematic electronic search was performed using MEDLINE, CINAHL, Embase, BIOSIS, and the Cochrane Library to identify studies published from inception up until December 2023. An adapted Downs and Black checklist was utilised to assess methodological quality and project risk of bias. Percentage agreement and nominal kappa statistics with bootstrapped bias-corrected 95% confidence intervals (CIs) were used. A comprehensive literature search revealed 277 citations for review, of which 210 studies entered full-text screening. In total, eight studies met the inclusion criteria for quality assessment by two independent reviewers. The results revealed variations in data quality, with scores ranging from 12 to 17 due to missing information related to subject characteristics, biomechanical model, and power calculation. This review reveals common compensation strategies associated with walking among non-operative children with Perthes disease such as Trendelenburg gait due to weakness of the hip abductor muscle.

Impact of residual stress on coronary plaque stress/strain calculations using optical coherence tomography image-based multi-layer models.

Mechanical stress and strain conditions play an important role in atherosclerosis plaque progression, remodeling and potential rupture and may be used in plaque vulnerability assessment for better clinical diagnosis and treatment decisions. Single layer plaque models without residual stress have been widely used due to unavailability of multi-layer image segmentation method and residual stress data. However, vessel layered structure and residual stress have large impact on stress/strain calculations and should be included in the models. In this study, intravascular optical coherence tomography (OCT) data of coronary plaques from 10 patients were acquired and segmented to obtain the three-layer vessel structure using an in-house automatic segmentation algorithm. Multi- and single-layer 3D thin-slice biomechanical plaque models with and without residual stress were constructed to assess the impact of residual stress on stress/strain calculations. Our results showed that residual stress led to a more uniform stress distribution across the vessel wall, with considerable plaque stress/strain decrease on inner wall and increase on vessel out-wall. Multi-layer model with residual stress inclusion reduced inner wall maximum and mean plaque stresses by 38.57% and 59.70%, and increased out-wall maximum and mean plaque stresses by 572.84% and 432.03%. These findings demonstrated the importance of multi-layer modeling with residual stress for more accurate plaque stress/strain calculations, which will have great impact in plaque cap stress calculation and plaque rupture risk assessment. Further large-scale studies are needed to validate our findings.

A methodology to restrict the range of motion of joints: Application to the ankle joint complex

One of the most critical aspects when developing biomechanical models is the formulation of the joints, which, in the case of the human body, have limited range of motion (RoM). Thus, restrictions to prevent joints from performing unacceptable movements and avoid unrealistic configurations of the adjacent bodies must be formulated. This study extends the authors’ previous work to demonstrate the potential of applying a methodology to restrict the RoM of joints to the complex case of the human ankle joint complex. The methodology applies joint resistance moments to the adjacent bodies to mimic the resistive and dissipative behavior of the constituent materials and to prevent unacceptable configurations of those bodies. A detailed description of the application of the methodology to the ankle joint complex is given, including the definition of the joint's local reference frames and circumduction cones, estimation of the longitude and latitude, calculation of the maximum latitude using the elliptical approach and the transfer of forces and moments to the adjacent bodies. The methodology correctly restricts the RoM of the ankle joint complex, producing physiologically sound simulation results.

Reinforcement Learning May Demystify the Limited Human Motor Learning Efficacy Due to Visual-Proprioceptive Mismatch.

Vision and proprioception have fundamental sensory mismatches in delivering locational information, and such mismatches are critical factors limiting the efficacy of motor learning. However, it is still not clear how and to what extent this mismatch limits motor learning outcomes. To further the understanding of the effect of sensory mismatch on motor learning outcomes, a reinforcement learning algorithm and the simplified biomechanical elbow joint model were employed to mimic the motor learning process in a computational environment. By applying a reinforcement learning algorithm to the motor learning of elbow joint flexion task, simulation results successfully explained how visual-proprioceptive mismatch limits motor learning outcomes in terms of motor control accuracy and task completion speed. The larger the perceived angular offset between the two sensory modalities, the lower the motor control accuracy. Also, the more similar the peak reward amplitude of the two sensory modalities, the lower the motor control accuracy. In addition, simulation results suggest that insufficient exploration rate limits task completion speed, and excessive exploration rate limits motor control accuracy. Such a speed-accuracy trade-off shows that a moderate exploration rate could serve as another important factor in motor learning.

A Normalization Strategy for Weakly Supervised 3D Hand Pose Estimation

The effectiveness of deep neural network models is intricately tied to the distribution of training data. However, in pose estimation, potential discrepancies in root joint positions and inherent variability in biomechanical features across datasets are often overlooked in current training strategies. To address these challenges, a novel Hand Pose Biomechanical Model (HPBM) is developed. In contrast to the traditional 3D coordinate-encoded pose, it provides a more intuitive depiction of the anatomical characteristics of the hand. Through this model, a data normalization approach is implemented to align the root joint and unify the biomechanical features of training samples. Furthermore, the HPBM facilitates a weakly supervised strategy for dataset expansion, significantly enhancing the data diversity. The proposed normalized method is evaluated on two widely used 3D hand pose estimation datasets, RHD and STB, demonstrating superior performance compared to the models trained without normalized datasets. Utilizing ground truth 2D keypoints as input, a reduction of 45.1% and 43.4% in error is achieved on the STB and RHD datasets, respectively. When leveraging 2D keypoints from MediaPipe, a reduction in error by 11.3% and 14.3% is observed on the STB and RHD datasets.

Assessing cows' mobility to determine their comfort state

Milk production and breeding of highly productive cows using modern innovative technologies have led to specific unfavorable combinations of technological factors in how cows are kept, which has significantly increased their susceptibility to developing various pathological processes in the musculoskeletal system. Lameness is the most common pathology. It is important to note that this information is based on objective evaluations and scientific research. The article is devoted to developing methodological approaches to determine the comfort state of cows based on mobility assessment. When determining the comfort state of a cow, in particular, the detection of diseases of the musculoskeletal system, a three-dimensional image of the animal was used, the position of the specified points of the animal's body was determined (tracking), the kinematic indicators of the movement of these points were calculated, the degree of bending of the animal's back during movement was assessed, complex mobility indicators were calculated, and the calculated complex mobility indicator was compared with the reference one. Based on the research results, a structural and technological scheme of a system for determining the comfort state of an animal based on the assessment of its mobility was developed, and software for video recording of movement was created. The step length, maximum step height, step duration, posture, and free state, as well as the speed of movement of healthy animals, those with single lesions and hoof ulcers were determined, and, as a result, the dynamics of changes in the accelerations of nodal points in the joints for each body link of healthy cows was revealed. The key variables of the biomechanical model for assessing the limbs of cattle (cows) are substantiated. The value of the specific force of the support reaction acting on the hooves of cows was determined: the highest value (9.8 N/kg) was observed for the concrete surface, the lowest (5 N/kg) – for rubber mats. The practical examples of the complex relationship between welfare indicators (lameness), elements of physiology (mobility), and technology (floor type) presented in the publication are recommended to be effectively used in monitoring the results of detecting gait disorders in animals and evaluating its effectiveness even in the early stages of the disease. The prospect of further research is to determine the comfort state of animals depending on environmental and climatic conditions.

Current practices in clinical gait analysis in Europe: A comprehensive survey-based study from the European society for movement analysis in adults and children (ESMAC) standard initiative

BackgroundClinical gait analysis (CGA) is a systematic approach to comprehensively evaluate gait patterns, quantify impairments, plan targeted interventions, and evaluate the impact of interventions. However, international standards for CGA are currently lacking, resulting in various national initiatives. Standards are important to ensure safe and effective healthcare practices and to enable evidence-based clinical decision-making, facilitating interoperability, and reimbursement under national healthcare policies. Collaborative clinical and research work between European countries would benefit from common standards. Research objectiveThis study aimed to review the current laboratory practices for CGA in Europe. MethodsA comprehensive survey was conducted by the European Society for Movement Analysis in Adults and Children (ESMAC), in close collaboration with the European national societies. The survey involved 97 gait laboratories across 16 countries. The survey assessed several aspects related to CGA, including equipment used, data collection, processing, and reporting methods. ResultsThere was a consensus between laboratories concerning the data collected during CGA. The Conventional Gait Model (CGM) was the most used biomechanical model for calculating kinematics and kinetics. Respondents also reported the use of video recording, 3D motion capture systems, force plates, and surface electromyography. While there was a consensus on the reporting of CGA data, variations were reported in training, documentation, data preprocessing and equipment maintenance practices. SignificanceThe findings of this study will serve as a foundation for the development of standardized guidelines for CGA in Europe.

Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism.

The plantar aponeurosis (PA) is an elastic longitudinal band that contributes to the generation of a propulsive force in the push-off phase during walking and running through the windlass mechanism. However, the dynamic behavior of the PA remains unclear owing to the lack of direct measurement of the strain it generates. Therefore, this study aimed to visualize and quantify the PA behavior during two distinct foot postures: (i) neutral posture and (ii) windlass posture with midtarsal joint plantarflexion and metatarsophalangeal joint dorsiflexion, using computed tomography scans. Six healthy adult males participated in the experiment, and three-dimensional reconstruction of the PA was conducted to calculate its path length, width, thickness, and cross-sectional area. This study successfully visualized and quantified the morphological changes in the PA induced by the windlass mechanism, providing a precise reference for biomechanical modeling. This study also highlighted the interindividual variability in the PA morphology and stretching patterns. Although the windlass posture was not identical to that observed in the push-off phase during walking, the observed PA behavior provides valuable insights into its mechanics and potential implications for foot disorders.

Patellar motion and dysfunction of its stabilizers in a biomechanical model of the knee joint

Patellar motion and dysfunction of its stabilizers in a biomechanical model of the knee joint

To what extent can mastication functionality be restored following mandibular reconstruction surgery? A computer modeling approach

Statement of ProblemAdvanced cases of head and neck cancer involving the mandible often require surgical removal of diseased sections and subsequent replacement with donor bone. During the procedure, the surgeon must make decisions regarding which bones or tissues to resect. This requires balancing tradeoffs related to issues such as surgical access and post-operative function; however, the latter is often difficult to predict, especially given that long-term functionality also depends on the impact of post-operative rehabilitation programs. PurposeTo assist in surgical decision-making, we present an approach for estimating the effects of reconstruction on key aspects of post-operative mandible function. Material and MethodsWe develop dynamic biomechanical models of the reconstructed mandible considering different defect types and validate them using literature data. We use these models to estimate the degree of functionality that might be achieved following post-operative rehabilitation. ResultsWe find significant potential for restoring mandibular functionality, even in cases involving large defects. This entails an average trajectory error below 2 mm, bite force comparable to a healthy individual, improved condyle mobility, and a muscle activation change capped at a maximum of 20%. ConclusionThese results suggest significant potential for adaptability in the masticatory system and improved post-operative rehabilitation, leading to greater restoration of jaw function.

Torque modulation mechanism of the knee joint during balance recovery

Exploring the torque modulation mechanisms of human joints is critical for analyzing the human balance control system and developing natural human-machine interactions for balance support. However, the knee joint is often overlooked in biomechanical models because of its limited range of motion during balance recovery. This poses a challenge in establishing mathematical models for the knee joint's torque modulation mechanisms using computer simulations based on the inverted pendulum model. This study aims to provide a simplified linear feedback model inspired by sensorimotor transformation theory to reveal the torque modulation mechanism of the knee joint. The model was validated using data from experiments involving support-surface translation perturbations. The goodness-of-fit metrics of the model, including R2 values and root mean square errors (RMSE), demonstrated strong explanatory power (R2 ranged from 0.77 to 0.90) and low error (RMSE ranging from 0.035 to 0.072) across different perturbation magnitudes and directions. Through pooling samples across various perturbation conditions and conducting multiple fits, this model revealed that knee torque is modulated using a direction-specific strategy with adaptable feedback gains. These results suggest that the proposed simplified linear model can be used to develop assistive systems and retrieve insights on balance recovery mechanisms.

Analysis of Aortic Arch Hemodynamics With Simulated Bird's Beak Effects.

The objective of this study was to investigate the flow effects in different degrees of thoracic aortic stent graft protrusion extension by creating bird beak effect simulations using accurate 3D geometry and a realistic, nonlinear, elastic biomechanical model using computer-aided software SolidWorks. Segmentation in 3D of an aortic arch from a computed tomography (CT) scan of a real-life patient was performed using SolidWorks. A parametric analysis of three models was performed: (A) Aortic arch with no stent, (B) 3mm bird-beak configuration, and (C) 6.5mm bird-beak configuration. Flow velocity, pressure, vorticity, wall shear stress (WSS), and time average WSS were assessed. The flow velocity in Model A remained relatively constant and low in the area of the ostium of the brachiocephalic artery and doubled in the left subclavian artery. On the contrary, Models B and C showed a decrease in velocity of 52.3 % in the left subclavian artery. Furthermore, Model B showed a drop in velocity of 82.7% below the bird-beak area, whereas Model C showed a decline of 80.9% in this area. The pressure inside the supra-aortic branches was higher in Model B and C compared with Model A. In Model A, vorticity only appeared at the level of the descending aorta, with low to non-vorticity in the aortic arch. In contrast, Models B and C had an average vorticity of 241.4Hz within the bird beak area. Regarding WSS, Model A, and Model B shared similar WSS in the peak systolic phase, in the aortic arch, and the bird beak area, whereas Model C had an increased WSS by 5Pa on average at these zones. In the present simulations' lower velocities, higher pressures, vortices, and WSS were observed around the bird beak zone, the aortic arch, and the supra-aortic vessels.

3D Kinematics Quantifies Gait Response to Levodopa earlier and to a more Comprehensive Extent than the MDS-Unified Parkinson's Disease Rating Scale in Patients with Motor Complications.

Quantitative 3D movement analysis using inertial measurement units (IMUs) allows for a more detailed characterization of motor patterns than clinical assessment alone. It is essential to discriminate between gait features that are responsive or unresponsive to current therapies to better understand the underlying pathophysiological basis and identify potential therapeutic strategies. This study aims to characterize the responsiveness and temporal evolution of different gait subcomponents in Parkinson's disease (PD) patients in their OFF and various ON states following levodopa administration, utilizing both wearable sensors and the gold-standard MDS-UPDRS motor part III. Seventeen PD patients were assessed while wearing a full-body set of 15 IMUs in their OFF state and at 20-minute intervals following the administration of a supra-threshold levodopa dose. Gait was reconstructed using a biomechanical model of the human body to quantify how each feature was modulated. Comparisons with non-PD control subjects were conducted in parallel. Significant motor changes were observed in both the upper and lower limbs according to the MDS-UPDRS III, 40 minutes after levodopa intake. IMU-assisted 3D kinematics detected significant motor alterations as early as 20 minutes after levodopa administration, particularly in upper limbs metrics. Although all "pace-domain" gait features showed significant improvement in the Best-ON state, most rhythmicity, asymmetry, and variability features did not. IMUs are capable of detecting motor alterations earlier and in a more comprehensive manner than the MDS-UPDRS III. The upper limbs respond more rapidly to levodopa, possibly reflecting distinct thresholds to levodopa across striatal regions.

Image-based biomarkers for engineering neuroblastoma patient-specific computational models

AbstractChildhood cancer is a devastating disease that requires continued research and improved treatment options to increase survival rates and quality of life for those affected. The response to cancer treatment can vary significantly among patients, highlighting the need for a deeper understanding of the underlying mechanisms involved in tumour growth and recovery to improve diagnostic and treatment strategies. Patient-specific models have emerged as a promising alternative to tackle the challenges in tumour mechanics through individualised simulation. In this study, we present a methodology to develop subject-specific tumour models, which incorporate the initial distribution of cell density, tumour vasculature, and tumour geometry obtained from clinical MRI imaging data. Tumour mechanics is simulated through the Finite Element method, coupling the dynamics of tumour growth and remodelling and the mechano-transport of oxygen and chemotherapy. These models enable a new application of tumour mechanics, namely predicting changes in tumour size and shape resulting from chemotherapeutic interventions for individual patients. Although the specific context of application in this work is neuroblastoma, the proposed methodologies can be extended to other solid tumours. Given the difficulty for treating paediatric solid tumours like neuroblastoma, this work includes two patients with different prognosis, who received chemotherapy treatment. The results obtained from the simulation are compared with the actual tumour size and shape from patients. Overall, the simulations provided clinically useful information to evaluate the effectiveness of the chemotherapy treatment in each case. These results suggest that the biomechanical model could be a valuable tool for personalised medicine in solid tumours.

Parametric Solid Models of the At-Term Uterus From Magnetic Resonance Images.

Birthing mechanics are poorly understood, though many injuries during childbirth are mechanical, like fetal and maternal tissue damage. Several biomechanical simulation models of parturition have been proposed to investigate birth, but many do not include the uterus. Additionally, most solid models rely on segmenting anatomical structures from clinical images to generate patient geometry, which can be time-consuming. This work presents two new parametric solid modeling methods for generating patient-specific, at-term uterine three-dimensional geometry. Building from an established method of modeling the sagittal uterine shape, this work improves the uterine coronal shape, especially where the fetal head joins the lower uterine wall. Solid models of the uterus and cervix were built from five at-term patients' magnetic resonance imaging (MRI) sets. Using anatomy measurements from MRI-segmented models, two parametric models were created-one that employs an averaged coronal uterine shape and one with multiple axial measurements of the coronal uterus. Through finite element analysis, the two new parametric methods were compared to the MRI-segmented high-fidelity method and a previously published elliptical low-fidelity method. A clear improvement in the at-term uterine shape was found using the two new parametric methods, and agreement in principal Lagrange strain directions was observed across all modeling methods. These methods provide an effective and efficient way to generate three-dimensional solid models of patient-specific maternal uterine anatomy, advancing possibilities for future research in computational birthing biomechanics.

Rethinking running biomechanics: a critical review of ground reaction forces, tibial bone loading, and the role of wearable sensors.

This study presents a comprehensive review of the correlation between tibial acceleration (TA), ground reaction forces (GRF), and tibial bone loading, emphasizing the critical role of wearable sensor technology in accurately measuring these biomechanical forces in the context of running. This systematic review and meta-analysis searched various electronic databases (PubMed, SPORTDiscus, Scopus, IEEE Xplore, and ScienceDirect) to identify relevant studies. It critically evaluates existing research on GRF and tibial acceleration (TA) as indicators of running-related injuries, revealing mixed findings. Intriguingly, recent empirical data indicate only a marginal link between GRF, TA, and tibial bone stress, thus challenging the conventional understanding in this field. The study also highlights the limitations of current biomechanical models and methodologies, proposing a paradigm shift towards more holistic and integrated approaches. The study underscores wearable sensors' potential, enhanced by machine learning, in transforming the monitoring, prevention, and rehabilitation of running-related injuries.