External Mechanical Work Research Articles

External Mechanical Work Versus Energy Expenditure During on-Court Tennis Drills in Elite Adolescent Tennis Players

Abstract Purpose Tennis demands exceptional technical skills, speed, strength and endurance. Previous studies have highlighted the high energy expenditure during tennis drills due to constant directional changes. While metabolic monitoring and player tracking have been used to quantify exercise intensity and movements, mechanical efficiency (ME) in tennis remains poorly understood. This study aimed to investigate ME in tennis by combining metabolic and mechanical measurements during on-court drills. Methods Ten elite adolescent tennis players (males n = 5, females n = 5) performed a VO2max test on a treadmill and participated in three standard tennis drills, Spanish cross, lateral and inside out. During the tennis drill, full-body kinematics were captured, and energy expenditure was measured using a portable breath-by-breath gas analysis. ME was calculated for each drill, and individual differences were examined. Results Results revealed significant differences in energy expenditure and mechanical work between drills. ME was not associated with VO2max or running speed. highlighting the need to focus on other factors like strength, footwork technique, and neuromuscular training to enhance ME. Conclusion This study underscores the complexity of ME in tennis, with individual variations and where factors like footwork technique, muscular strength and motor abilities might influence ME.

Peak Oxygen Uptake is Slope Dependent: Insights from Ground Reaction Forces and Muscle Oxygenation in Trained Male Runners

BackgroundThe aim of this study is to explore the effect of treadmill slope on ground reaction forces and local muscle oxygenation as putative limiting factors of peak oxygen uptake in graded maximal incremental running tests. Thirteen trained male runners completed five maximal incremental running tests on treadmill at − 15%, − 7.5%, 0%, 7.5% and 15% slopes while cardiorespiratory and local muscle oxygenation responses as well as ground reaction forces were continuously recorded. Blood lactate concentration and isometric knee extensor torque were measured before and after each test.ResultsPeak oxygen uptake was lower at − 15% slope compared to all other conditions (from − 10 to − 17% lower, p < 0.001), with no difference between − 7.5 and + 15% slope. Maximal heart rate and ventilation values were reached in all conditions. The negative external mechanical work increased from steep uphill to steep downhill slopes (from 6 to 92% of total external work) but was not correlated with the peak oxygen uptake reduction. Local muscle oxygenation remained higher in − 15% slope compared to level running (p = 0.003).ConclusionsSimilar peak oxygen uptake can be reached in downhill running up to − 7.5% slope. At more severe downhill slopes (i.e., − 15%), greater negative muscle work and limited local muscle deoxygenation occurred, even in subjects familiarized to downhill running, presumably preventing the achievement of similar to other condition’s peak oxygen uptake.Key PointsTrained male runners can reach like level running V̇O2peak at moderate but not at severe negative slope.Negative external mechanical work increases with increasing negative slope.At maximal intensity Vastus Lateralis muscle oxygenation is higher in steep negative slope.Knee extensor isometric muscle torque is preserved after maximal level and uphill running, but reduced after downhill running, despite lower blood lactate.Progressive reduction of V̇O2 at maximal effort with increasing negative slope might be related to the metabolic consequences of increased lower limb negative external work (i.e., eccentric muscle actions).

The work to swing limbs in humans versus chimpanzees and its relation to the metabolic cost of walking

Compared to their closest ape relatives, humans walk bipedally with lower metabolic cost (C) and less mechanical work to move their body center of mass (external mechanical work, WEXT). However, differences in WEXT are not large enough to explain the observed lower C: humans may also do less work to move limbs relative to their body center of mass (internal kinetic mechanical work, WINT,k). From published data, we estimated differences in WINT,k, total mechanical work (WTOT), and efficiency between humans and chimpanzees walking bipedally. Estimated WINT,k is ~ 60% lower in humans due to changes in limb mass distribution, lower stride frequency and duty factor. When summing WINT,k to WEXT, between-species differences in efficiency are smaller than those in C; variations in WTOT correlate with between-species, but not within-species, differences in C. These results partially support the hypothesis that the low cost of human walking is due to the concerted low WINT,k and WEXT.

Relationship between indicators of physical development and indicators of anaerobic productivity of the body of women 25-35 years old

Purpose. To establish the relationship between body mass, body composition with indicators of anaerobic productivity of women aged 25-35.&#x0D; Materials and methods. 392 women aged 25-35 years participated in the study. The power of anaerobic alactate productivity was determined by the 10-second Wingate test. The power of anaerobic lactate productivity was determined by the 30-second Wingate test. The capacity of anaerobic lactate productivity was determined by the e maximum amount of external mechanical work per 1 minute. Body fat percentage, body muscle percentage, and visceral fat content were determined by the bioelectrical impedance method.&#x0D; The results. It was found that the correlation of body mass, body mass index and percentage of the muscle component of women aged 25-35 with performance in anaerobic tests is characterized as direct. The degree of correlation of indicators of physical development with absolute indicators of anaerobic productivity is higher than with relative indicators. Performance in anaerobic tests is most strongly correlated with body mass and body mass index. The degree of correlation of body mass, body mass index with tests characterizing the power of anaerobic alactate and lactate productivity of the body corresponds to "high". A "high" degree of correlation of the capacity of anaerobic lactate productivity of the body was established only with body mass.&#x0D; Conclusions. Among indicators of physical development, body mass and body mass index have the greatest influence on the anaerobic capabilities of the body of women aged 25-35, who do not play sports. Higher values of body mass and body mass index are predictive of higher level of anaerobic productivity. The high degree of correlation with body mass and body mass index is due to the specifics of the cycle ergometeric tests. Running anaerobic tests will not give a direct correlation of a high degree, because they are related to the movement of body weight along the distance. The percentage content of fat and muscle components, the level of visceral fat cannot be predictors of the level of anaerobic productivity of the body in women who do not do sports.

Human-in-the-loop optimization of rocker shoes via different cost functions during walking

Personalised footwear could be used to enhance the function of the foot–ankle complex to a person’s maximum. Human-in-the-loop optimization could be used as an effective and efficient way to find a personalised optimal rocker profile (i.e., apex position and angle). The outcome of this process likely depends on the selected optimization objective and its responsiveness to the rocker parameters being tuned. This study aims to explore whether and how human-in-the-loop optimization via different cost functions (i.e., metabolic cost, collision work as measure for external mechanical work, and step distance variability as measure for gait stability) affects the optimal apex position and angle of a rocker profile differently for individuals during walking. Ten healthy individuals walked on a treadmill with experimental rocker shoes in which apex position and angle were optimized using human-in-the-loop optimization using different cost functions. We compared the obtained optimal apex parameters for the different cost functions and how these affected the selected gait related objectives. Optimal apex parameters differed substantially between participants and optimal apex positions differed between cost functions. The responsiveness to changes in apex parameters differed between cost functions. Collision work was the only cost function that resulted in a significant improvement of its performance criteria. Improvements in metabolic cost or step distance variability were not found after optimization. This study showed that cost function selection is important when human-in-the-loop optimization is used to design personalised footwear to allow conversion to an optimum that suits the individual.

Interlimb Coordination during Double Support Phase of Gait in People with and without Stroke

This study aims to identify differences between participants with and without stroke regarding the ipsilesional and contralesional lower limbs kinematics, kinetics, muscle activity and their variability during double support phase of gait. Eleven post-stroke and thirteen healthy participants performed 10 gait trials at a self-selected speed while being monitored by an optoelectronic motion capture system, two force plates and an electromyographic system. The following outcomes were evaluated during the double support: the time and the joint position; the external mechanical work on the centre of mass; and the relative electromyographic activity. Both, contralesional/ipsilesional and dominant/non-dominant of participants with and without stroke, respectively, were evaluated during double support phase of gait in trailing or leading positions. The average value of each parameter and the coefficient of variation of the 10 trials were analysed. Post-stroke participants present bilateral decreased mechanical work on the centre of mass and increased variability, decreased contralesional knee and ankle flexion in trailing position, increased ipsilesional knee flexion in leading position and increased variability. Increased relative muscle activity was observed in post-stroke participants with decreased variability. Mechanical work on the centre of mass seems to be the most relevant parameter to identify interlimb coordination impairments in post-stroke subjects.

It is not just the work you do, but how you do it: the metabolic cost of walking uphill and downhill with varying grades.

The cost of walking and running on uneven terrain is not directly explained by external mechanical work. Although metabolic cost of transport increases linearly with gradient at uphill and downhill gradients exceeding 15%, at shallower gradients, the relationship is nonlinear, with the minimum cost occurring at ∼10% downhill grade. Given these nonlinear relationships between grade and metabolic cost, we projected a significant difference in the total metabolic cost of two walking conditions that required the same total external mechanical work be performed over the same total period of time; in one condition, time was spent walking to gradients that were fixed at +10.5% and -10.5% and in the other condition time was spent walking to gradients that varied from 0 to +21% and from -21 to 0%. We compared these two conditions experimentally, using an approach to quantify nonsteady-state oxidative energy expenditure. In line with our projection, the "variable" grade condition resulted in an 8.3 ± 2.2% higher total cumulative oxidative energy expenditure (J·kg-1) compared with the "fixed" grade condition (P < 0.001). Future work should aim to apply our approach across different gradients, speeds, and forms of locomotion; especially those that might provide insight into how humans optimize locomotion on variable grade routes.NEW & NOTEWORTHY We use a method for quantifying nonsteady-state energetics to show that regardless of whether the same total gain and loss in elevation (i.e., same total external mechanical work) is achieved over the same period of time, the total energy expenditure of different graded walking conditions can vary depending on the grades that are walked at and for how long they are walked at.

Biomechanical adaptations during exhaustive runs at 90 to 120% of peak aerobic speed

The aim of this study was to examine how running biomechanics (spatiotemporal and kinetic variables) adapt with exhaustion during treadmill runs at 90, 100, 110, and 120% of the peak aerobic speed (PS) of a maximal incremental aerobic test. Thirteen male runners performed a maximal incremental aerobic test on an instrumented treadmill to determine their PS. Biomechanical variables were evaluated at the start, mid, and end of each run until volitional exhaustion. The change of running biomechanics with fatigue was similar among the four tested speeds. Duty factor and contact and propulsion times increased with exhaustion (P ≤ 0.004; F ≥ 10.32) while flight time decreased (P = 0.02; F = 6.67) and stride frequency stayed unchanged (P = 0.97; F = 0.00). A decrease in vertical and propulsive peak forces were obtained with exhaustion (P ≤ 0.002; F ≥ 11.52). There was no change in the impact peak with exhaustion (P = 0.41; F = 1.05). For runners showing impact peaks, the number of impact peaks increased (P ≤ 0.04; {upchi }^{2} ≥ 6.40) together with the vertical loading rate (P = 0.005; F = 9.61). No changes in total, external, and internal positive mechanical work was reported with exhaustion (P ≥ 0.12; F ≤ 2.32). Results suggest a tendency towards a “smoother” vertical and horizontal running pattern with exhaustion. A smoother running pattern refers to the development of protective adjustments, leading to a reduction of the load applied to the musculoskeletal system at each running step. This transition seemed continuous between the start and end of the running trials and could be adopted by the runners to decrease the muscle force level during the propulsion phase. Despite these changes with exhaustion, there were no changes in either gesture speed (no alteration of stride frequency) or positive mechanical work, advocating that runners unconsciously organize themselves to maintain a constant whole-body mechanical work output.

Repeatability and Temporal Consistency of Lower Limb Biomechanical Variables Expressing Interlimb Coordination during the Double-Support Phase in People with and without Stroke Sequelae

Reliable biomechanical methods to assess interlimb coordination during the double-support phase in post-stroke subjects are needed for assessing movement dysfunction and related variability. The data obtained could provide a significant contribution for designing rehabilitation programs and for their monitorisation. The present study aimed to determine the minimum number of gait cycles needed to obtain adequate values of repeatability and temporal consistency of lower limb kinematic, kinetic, and electromyographic parameters during the double support of walking in people with and without stroke sequelae. Eleven post-stroke and thirteen healthy participants performed 20 gait trials at self-selected speed in two separate moments with an interval between 72 h and 7 days. The joint position, the external mechanical work on the centre of mass, and the surface electromyographic activity of the tibialis anterior, soleus, gastrocnemius medialis, rectus femoris, vastus medialis, biceps femoris, and gluteus maximus muscles were extracted for analysis. Both the contralesional and ipsilesional and dominant and non-dominant limbs of participants with and without stroke sequelae, respectively, were evaluated either in trailing or leading positions. The intraclass correlation coefficient was used for assessing intra-session and inter-session consistency analysis. For most of the kinematic and the kinetic variables studied in each session, two to three trials were required for both groups, limbs, and positions. The electromyographic variables presented higher variability, requiring, therefore, a number of trials ranging from 2 to >10. Globally, the number of trials required inter-session ranged from 1 to >10 for kinematic, from 1 to 9 for kinetic, and 1 to >10 for electromyographic variables. Thus, for the double support analysis, three gait trials were required in order to assess the kinematic and kinetic variables in cross-sectional studies, while for longitudinal studies, a higher number of trials (>10) were required for kinematic, kinetic, and electromyographic variables.

Ionotronics for reverse actuation.

In the midst of an ongoing energy crisis, the search for new methods of energy harvesting has never been more important. Here we explore, analyse and discuss principles of ionotronic reverse-actuator devices based on the effect of double-layer charging. The designs that we consider in this paper operate based on a common principle - using external mechanical work, which would otherwise be wasted, to produce changes in the contact area of electrode and electrolyte, translated into the time variation of the double-layer capacitance. Periodic variation of capacitance, when connected to a reference voltage source, produces alternating electric current through a load. This concept is not new and in some forms was realised in the early works of Boland, Krupenkin and several papers of our group. The goal of the present paper is to build a comprehensive analytical platform for a description of operation of such devices in terms of materials, generated power as a function of the frequency of variation of applied force, electrical load, and other factors; the understanding of which allows us to optimise these systems and navigate their construction. The first design, discussed in the paper, is based on flat electrodes. It is the simplest one and, as such, helps elucidate some key factors determining power generation. While being easy to realise experimentally, it generates relatively low power, even when optimised. The second design, based on microporous electrodes is more sophisticated and allows a much larger power harvest. The results are also compared to the recently proposed capacitive rotor device. The developed theory is set to capture the key factors that determine the functioning of the considered reverse actuators. The structures under study are matched to fit into the sole of a shoe and produce power from walking and running. However, they can also be scaled-up to larger operating systems and various external loads.

Use of gas reduction energy at a gas distribution station

The issue of utilization of excess energy of throttled natural gas is still relevant today. To solve it, various devices are used, based on such principles as on the Ranque-Hilsch vortex effect, temperature stratification using the Leontief tube, expander-generator sets and devices based on the Hartmann-Sprenger effect. One of the most common devices at gas distribution stations (gas gate station) is the turboexpander. The principle of its operation is based on the expansion of the gas flow with the performance of external mechanical work. Taking into account the increased interest in hydrogen fuel in connection with the course announced by the UN for decarbonization of production by 2050, the modern gas transmission system can become a secondary source of electricity for hydrogen production, thereby solving the problem of excess pressure energy utilization at gas distribution stations. The technological solution for using this energy is the installation of turboexpanders and electrolysis of water at gate stations in order to produce hydrogen.

Liquid Crystal-Based Organosilicone Elastomers with Supreme Mechanical Adaptability.

Elastomers with supreme mechanical adaptability where the increasing stress under continuous deformation is significantly inhibited within a large deformation zone, are highly desired in many areas, such as artificial muscles, flexible and wearable electronics, and soft artificial-intelligence robots. Such system comprises the advantages of recoverable elasticity and internal compensation to external mechanical work. To obtain elastomer with supreme mechanical adaptability, a novel liquid crystal-based organosilicon elastomer (LCMQ) is developed in this work, which takes the advantages of reversible strain-induced phase transition of liquid crystal units in polymer matrix and the recoverable nano-sized fillers. The former is responsible for the inhibition of stress increasing during deformation, where the external work is mostly compensated by internal phase transition, and the latter provides tunable and sufficient high tensile strength. Such LCMQs were synthesized with 4-methoxyphenyl 4-(but-3-en-1-yloxy)benzoate (MBB) grafted thiol silicone oil (crosslinker-g-MBB) as crosslinking agent, vinyl terminated polydimethylsiloxane as base adhesive, and fumed silica as reinforcing filler by two-step thiol-ene “click” reaction. The obtained tensile strength and the elongation at break are better than previously reported values. Moreover, the resulting liquid crystal elastomers exhibit different mechanical behavior from conventional silicone rubbers. When the liquid crystal content increases from 1% (w/w) to 4% (w/w), the stress plateau for mechanical adaptability becomes clearer. Moreover, the liquid crystal elastomer has no obvious deformation from 25 °C to 120 °C and is expected to be used in industrial applications. It also provides a new template for the modification of organosilicon elastomers.

Effects of walking speed and prosthetic knee control type on external mechanical work in transfemoral prosthesis users

During human locomotion, each limb performs step-to-step work on the body center of mass to maintain forward walking. This energy exchange relies on physiological mechanisms which are altered or impaired in transfemoral prosthesis users (TFPUs). Exploring step-to-step energy exchange modifications displayed by TFPUs at greater walking speeds may provide insight into their means for improving gait efficiency. The primary aim of this study was to characterize the effects of walking speed on mechanical work in unilateral TFPUs. The secondary aim assessed the effect of prosthetic knee (microprocessor, mechanical passive) on limb collision work. Twenty-five TFPUs walked with their customary prosthesis on a split-belt instrumented treadmill at eight speeds (0.55–1.53 m/s range), and collision, midstance, and push-off work were calculated for each limb. TFPUs displayed a significant (p < 0.001) bilateral increase in collision work with increased walking speed, but midstance and push-off work increased only for the sound limb and remained nearly constant for the prosthetic limb. TFPUs displayed significantly (p < 0.001) less push-off work generated by the prosthetic limb across all speeds. A microprocessor knee was associated with reduced sound limb collision work across speeds with the peak (negative) power being significantly greater for mechanical knees (p = 0.032). Results suggest that TFPU gait inefficiency may be related to a near complete loss of energy transfer on the prosthetic limb, relying on the sound limb to drive energy changes. Such reliance emphasizes need for attention to the long-term effects on sound limb health and possible benefit of microprocessor knees to offset that impact.

External Mechanical Work in Runners With Unilateral Transfemoral Amputation.

Carbon-fiber running-specific prostheses have enabled individuals with lower extremity amputation to run by providing a spring-like leg function in their affected limb. When individuals without amputation run at a constant speed on level ground, the net external mechanical work is zero at each step to maintain a symmetrical bouncing gait. Although the spring-like “bouncing step” using running-specific prostheses is considered a prerequisite for running, little is known about the underlying mechanisms for unilateral transfemoral amputees. The aim of this study was to investigate external mechanical work at different running speeds for unilateral transfemoral amputees wearing running-specific prostheses. Eight unilateral transfemoral amputees ran on a force-instrumented treadmill at a range of speeds (30, 40, 50, 60, 70, and 80% of the average speed of their 100-m personal records). We calculated the mechanical energy of the body center of mass (COM) by conducting a time-integration of the ground reaction forces in the sagittal plane. Then, the net external mechanical work was calculated as the difference between the mechanical energy at the initial and end of the stance phase. We found that the net external work in the affected limb tended to be greater than that in the unaffected limb across the six running speeds. Moreover, the net external work of the affected limb was found to be positive, while that of the unaffected limb was negative across the range of speeds. These results suggest that the COM of unilateral transfemoral amputees would be accelerated in the affected limb’s step and decelerated in the unaffected limb’s step at each bouncing step across different constant speeds. Therefore, unilateral transfemoral amputees with passive prostheses maintain their bouncing steps using a limb-specific strategy during running.

Biomechanical responses of Nordic walking in people with Parkinson's disease.

In healthy adults, Nordic walking (NW) is known to increase the external mechanical energy fluctuations, though the external work is unaltered due to an improved pendulum-like recovery in comparison with free walking (FW). We aimed to compare mechanical, pendulum-like, and spatiotemporal parameters of gait at different speeds with and without NW poles in people with Parkinson's disease and healthy controls. The study included 11 people (aged 65.6±7.0years) with idiopathic Parkinson's disease, scoring between 1 and 1.5 on the Hoehn and Yahr scale (H&Y), and nine healthy controls (aged 70.0±5.6years). All the people were experienced Nordic walkers. Walking tests were performed at 1.8kmh-1 and 4.7kmh-1 , on eight 3D force platforms on a walkway. We found greater pendulum-like energy recovery (p<0.05) in the Parkinson group during NW than in FW, while external mechanical work remained similar (p>0.05). People with Parkinson's disease showed a major increase in vertical and forward energy fluctuations using poles than in healthy controls. In addition, the Parkinson group showed increased stride frequency and reduced stride length compared to controls in the NW and FW conditions. Our findings partly justify the lower walking economy in Parkinson's disease due to reduced pendulum-like mechanism at commonly used speeds. NW alters gait mechanics similarly in Parkinson group and healthy control, increasing the total mechanical work. Therefore, NW can be a compelling strategy for rehabilitation because of its potential for improving functional mobility, increasing pendulum-like mechanism in Parkinson's disease.

Action and Entropy in Heat Engines: An Action Revision of the Carnot Cycle.

Despite the remarkable success of Carnot’s heat engine cycle in founding the discipline of thermodynamics two centuries ago, false viewpoints of his use of the caloric theory in the cycle linger, limiting his legacy. An action revision of the Carnot cycle can correct this, showing that the heat flow powering external mechanical work is compensated internally with configurational changes in the thermodynamic or Gibbs potential of the working fluid, differing in each stage of the cycle quantified by Carnot as caloric. Action (@) is a property of state having the same physical dimensions as angular momentum (mrv = mr2ω). However, this property is scalar rather than vectorial, including a dimensionless phase angle (@ = mr2ωδφ). We have recently confirmed with atmospheric gases that their entropy is a logarithmic function of the relative vibrational, rotational, and translational action ratios with Planck’s quantum of action ħ. The Carnot principle shows that the maximum rate of work (puissance motrice) possible from the reversible cycle is controlled by the difference in temperature of the hot source and the cold sink: the colder the better. This temperature difference between the source and the sink also controls the isothermal variations of the Gibbs potential of the working fluid, which Carnot identified as reversible temperature-dependent but unequal caloric exchanges. Importantly, the engine’s inertia ensures that heat from work performed adiabatically in the expansion phase is all restored to the working fluid during the adiabatic recompression, less the net work performed. This allows both the energy and the thermodynamic potential to return to the same values at the beginning of each cycle, which is a point strongly emphasized by Carnot. Our action revision equates Carnot’s calorique, or the non-sensible heat later described by Clausius as ‘work-heat’, exclusively to negative Gibbs energy (−G) or quantum field energy. This action field complements the sensible energy or vis-viva heat as molecular kinetic motion, and its recognition should have significance for designing more efficient heat engines or better understanding of the heat engine powering the Earth’s climates.

Effects of prolonged-release fampridine on multiple sclerosis-related gait impairments. A crossover, double-blinded, placebo-controlled study

BackgroundPeople with multiple sclerosis have reduced walking speed and impaired gait pattern. Prolonged release-fampridine is a potassium channel blocker that improves nerve conduction in patients with multiple sclerosis, leading to walking benefits. Whether fampridine alters gait pattern is unknown. MethodsIn this crossover, randomized controlled trial, patients with multiple sclerosis were tested for responder status during a 4-week run-in period. Patients were considered responders if they improved their 25-ft walk test by 10% and improved their perceived walking capacity. Responders were randomized to prolonged release-fampridine (10 mg b.i.d.) or placebo for a 6-week period. After a 2-week wash-out period, they were allocated to the other treatment for 6 weeks. Participants were assessed before and after both conditions. Three-dimensional gait analysis assessed kinematic, kinetic, mechanic and energetic variables while walking on a treadmill at comfortable speed. Six-minute walk test and 25-ft walk test were used to assess walking speed on middle and short-distances, respectively. Patient-reported outcome measures were also used. Repeated measures ANCOVAs were applied to assess the treatment effects. FindingsOut of 39 included patients, 24 responders (12 women; Expanded Disability Status Scale:4.25[4–5]; age:46 ± 10 years; maximal speed:0.93 ± 0.38 m·s−1) were identified. Among them, prolonged release-fampridine reduced the external mechanical work (−0.039 J·kg−1·m−1;p = 0.02), and improved knee flexion during swing phase (+5.3°; p = 0.02). No differences were found in other walking tests and patient-reported outcomes, at group-level. InterpretationProlonged release-fampridine increases knee flexion during swing phase and lowers mechanical external work. Whether these changes are related to clinically meaningful improvements in walking capacity and other functional variables should be further investigated.

Alloy design by tailoring phase stability in commercial Ti alloys

The mechanical characteristics and the operative deformation mechanisms of a metallic alloy can be optimised by explicitly controlling phase stability. Here an integrated thermoelastic and pseudoelastic model is presented to evaluate the β stability in Ti alloys. The energy landscape of β→α′/α″ martensitic transformation was expressed in terms of the dilatational and transformational strain energy, the Gibbs free energy change, the external mechanical work as well as the internal frictional resistance. To test the model, new alloys were developed by tailoring two base alloys, Ti–6Al–4V and Ti–6Al–7Nb, with the addition of β-stabilising element Mo. The alloys exhibited versatile mechanical behaviours with enhanced plasticity. Martensitic nucleation and growth was fundamentally dominated by the competition between elastic strain energy and chemical driving force, where the latter term tends to lower the transformational energy barrier. The model incorporates thermodynamics and micromechanics to quantitatively investigate the threshold energy for operating transformation-induced plasticity and further guides alloy design.

Effect of assist-as-needed robotic gait training on the gait pattern post stroke: a randomized controlled trial

BackgroundRegaining gait capacity is an important rehabilitation goal post stroke. Compared to clinically available robotic gait trainers, robots with an assist-as-needed approach and multiple degrees of freedom (AANmDOF) are expected to support motor learning, and might improve the post-stroke gait pattern. However, their benefits compared to conventional gait training have not yet been shown in a randomized controlled trial (RCT). The aim of this two-center, assessor-blinded, RCT was to compare the effect of AANmDOF robotic to conventional training on the gait pattern and functional gait tasks during post-stroke inpatient rehabilitation.MethodsThirty-four participants with unilateral, supratentorial stroke were enrolled (< 10 weeks post onset, Functional Ambulation Categories 3–5) and randomly assigned to six weeks of AANmDOF robotic (combination of training in LOPES-II and conventional gait training) or conventional gait training (30 min, 3–5 times a week), focused on pre-defined training goals. Randomization and allocation to training group were carried out by an independent researcher. External mechanical work (WEXT), spatiotemporal gait parameters, gait kinematics related to pre-defined training goals, and functional gait tasks were assessed before training (T0), after training (T1), and at 4-months follow-up (T2).ResultsTwo participants, one in each group, were excluded from analysis because of discontinued participation after T0, leaving 32 participants (AANmDOF robotic n = 17; conventional n = 15) for intention-to-treat analysis. In both groups, WEXT had decreased at T1 and had become similar to baseline at T2, while gait speed had increased at both assessments. In both groups, most spatiotemporal gait parameters and functional gait tasks had improved at T1 and T2. Except for step width (T0–T1) and paretic step length (T0–T2), there were no significant group differences at T1 or T2 compared to T0. In participants with a pre-defined goal aimed at foot clearance, paretic knee flexion improved more in the AANmDOF robotic group compared to the conventional group (T0–T2).ConclusionsGenerally, AANmDOF robotic training was not superior to conventional training for improving gait pattern in subacute stroke survivors. Both groups improved their mechanical gait efficiency. Yet, AANmDOF robotic training might be more effective to improve specific post-stroke gait abnormalities such as reduced knee flexion during swing.Trial registration Registry number Netherlands Trial Register (www.trialregister.nl): NTR5060. Registered 13 February 2015.

Acute response to cardiac re-synchronization therapy: ventricular properties adaptation?

Abstract Background Cardiac re-synchronization therapy (CRT) reduces mortality and hospitalization in patients with heart failure, reduced left ventricular ejection fraction (LVEF) and left bundle branch block (LBBB). However, there is no conclusive evidence on baseline parameters able to discriminate responder vs non-responder patients. Purpose In this study, we tested whether echocardiographic parameters describing LV dyssynchrony and efficiency may predict an acute LV recovery after CRT and whether lead position can modify such relationship. Methods We enrolled 65 consecutive patients (75% males, aged 71.2±10.5 years) referred for CRT according to current guidelines; 45% had an underlying ischaemic cardiopathy and 1/3 of them presented diabetes mellitus. We performed a CRT-off and CRT–on 2D and 3D echocardiography during devices optimization (time between programming change 10/12 min). We evaluated ventricular dyssynchrony by speckle-tracking analysis based on temporary uniformity of strain (TUS) 3D longitudinal and circumferential. We also derived non-invasive myocardial efficiency (Effic) by interaction between pressure work index (PWI), representing an estimation of myocardial oxygen consumption, and mechanical external work. We indicated as concordant those patients presenting a LV lead position (defined from a chest X-ray using 2 orthogonal views) in the same segment as the latest systolic 3D circumferential strain curves. Results In the CRT-on phase, a non-statistically significant raise in LVEF was observed [from 0.37 (0.28–0.46) to 0.41 (0.34–0.47), p=0.27]. No improvement in both longitudinal and circumferential 3D TUS was demonstrated during CRT-on (p=0.44 and 0.47, respectively). Conversely, the gain in Effic from CRT-off to CRT-on phase was overall significant (from 0.43±0.14 to 0.50±0.16; p&amp;lt;0.001). After switching to CRT-on, the increase in longitudinal 3D TUS was higher in concordant compared to discordant patients (from 0.83±0.08 to 0.87±0.07 vs 0.88±0.11 to 0.87±0.12, respectively), but without significant interaction (interaction p 0.24). No interaction was also found between variations of PWI after switching to CRT-on and LV lead position (concordant: from 12.99±4.18 to 12.84±2.99 ml/min/100g; discordant: from 13.58±3.89 to 13.95±3.97 ml/min/100g; interaction p 0.75). Conclusions Effic was overall acutely augmented during CRT-on phase in patients with LV dysfunction undergoing cardiac re-synchronization. In the acute phase, no significant relationship between LV changes in speckle-tracking analyses after CRT and LV lead position was found. 2-way ANOVA for myocardial efficiency Funding Acknowledgement Type of funding source: None