Indentation Device Research Articles

The Impact of Intraocular Pressure Changes on Corneal Biomechanics in Primary Open-angle Glaucoma

PurposeTo investigate the relationship between intraocular pressure (IOP) changes and corneal biomechanical properties, determine the quantitative relationship between IOP changes and corneal biomechanical properties in patients with glaucoma and observe the differences among different types of glaucoma when the effects of high-level IOP were excluded. DesignProspective clinical cohort study. MethodsSetting: Institutional. Patients: Treatment-naive patients with primary open-angle glaucoma or ocular hypertension (OHT) were included. Observation Procedures: IOP was measured using a Goldmann applanation tonometer. Corneal biomechanics were evaluated using a corneal indentation device and corneal visualization Scheimpflug technology. Medication therapy was used for IOP reduction. Repeated measurements were taken at the baseline visit and each week thereafter within a month. Paired t tests were used to compare IOP and corneal biomechanical metrics before and after IOP-lowering therapy. One-way analysis of variance was employed to investigate potential differences across groups, with a Bonferroni post hoc correction administered for multiple intergroup comparisons. Main Outcome Measures: Corneal biomechanical parameters following IOP changes. ResultsEighty-one participants (mean age, 41.63 ± 17.33 years) were included in this study. The cohort comprised 20 patients with normal-tension glaucoma (NTG), 47 with high-tension glaucoma (HTG), and 14 with OHT. The baseline corneal stiffness (88.58±18.30 N/m) and corneal modulus (0.71±0.16 MPa) were greater than the post-IOP reduction values (67.15±9.24 N/m and 0.54±0.08 MPa, respectively; P<0.001). The relationships between changes in IOP and changes in corneal biomechanical parameters were Δ corneal stiffness=2.06*ΔIOP+6.47 (P<0.001) and Δ corneal modulus=0.017*ΔIOP+0.051 (P<0.001). After IOP reduction, the mean corneal stiffness at the 4th week in the NTG group was significantly lower (60.97±6.36 N/m) than that in the HTG (67.25±9.01 N/m) and OHT (75.62±6.52 N/m, P < 0.001) groups. Additionally, the stiffness of HTG patients was lower than that of OHT patients (P = 0.003). ConclusionsChanges in IOP have an impact on corneal biomechanical parameters. Decreases in corneal stiffness and modulus were observed after IOP reduction. When the effect of high-level IOP was excluded, corneal biomechanics varied according to the type of glaucoma. The HTG corneas were softer than the OHT corneas, and the NTG corneas were even softer.

Assessment of Intraday Variations in Skin Indentation Resistance.

Information about the mechanical properties of skin and their changes with age and other conditions is important to help characterize skin physiology and pathological changes. One method to obtain this information is to measure the force required to indent the skin to a specified indentation depth (FORCE). This process measures the tissue's resistance to indentation or its compressibility and is related to the tissue's elastic modulus. Since such measurements are made in clinical and other settings at various times of day (TOD), it is useful to estimate the extent of intraday variations in FORCE that may be expected. This report focuses on this issue. FORCE was self-measured on the volar forearm, 5 cm distal to the antecubital fossa, every two hours from 08:00 to 24:00 hours on two consecutive days by 12 medical students (six females and six males) who were trained in the measurement process using an indentation device (SkinFibroMeter). Variability in FORCE versus TOD was analyzed using the nonparametric Friedman test and differences between genders by the nonparametric Wilcoxon test. Differences between the first day (day 1) and the second day (day 2) were tested at each TOD. The whole-body fat percentage (FAT%) and water percentage (H2O%) were determined for each participant via bioimpedance measurements at 50 KHz. The age and BMI of the combined group (mean ± SD) were 24.5 ± 1.5 years and 23.2 ± 3.3 kg/m2.The overall average FORCE (mean ± SD) for the day over the 16 hours was 84.1 ± 22.7 mN and for day 2, it was 83.4 ± 28.5 mN with no significant difference between day 1 and day 2. For females, the overall two-day average FORCE (mean ± SD) over the 16 hours was 81.8 ± 20.3 mN and for males, it was 85.7 ± 30.1 mN with no significant difference between them (p = 0.271). Overall, there was no statistically significant difference in FORCE among TOD (p = 0.568). FORCE was not correlated with either FAT%, HTO%, or BMI. The findings indicate no statistically significant variation in indentation force in females, males, or combined concerning the TODof the measurement or differences between consecutive days at corresponding times. This suggests that whether such measurements are done in a research setting or within a clinic, they can be done at various TODwith minimal expected variation for a given subject. However, an extension of these findings to persons with skin conditions or ages not herein evaluated must await further study.

Comparative Analysis and Error Assessment of Nanoindentation Evaluation Techniques for NafionTM117

AbstractAdvances in the application of polymers for electrochemical cells require an understanding of their viscous deformation mechanisms and their interaction with moisture. Nanoindentation offers a localized, microscale testing alternative to traditional tensile testing. However, the viscoelastic nature of the polymers, combined with their increased compliance, presents challenges in the analysis of nanoindentation results. In addition, the dependence on moisture results in significant scatter and low repeatability. This study combines nanoindentation and tensile testing as a verification method and compares different correction protocols for static nanoindentation to investigate the mechanical behavior of polymer electrolyte membranes. Comparisons of different indentation devices, analysis methods, and indentation protocols show a significant overestimation of Young’s modulus using the classical Oliver–Pharr method compared to values determined from tensile tests. Nanoindentation at different humidity levels revealed different mechanisms leading to a decrease in Young’s modulus and hardness with increasing humidity.

Evaluating the Effects of Pulsed Electrical Stimulation on the Mechanical Behavior and Microstructure of Medulla Oblongata Tissues.

The development of remote surgery hinges on comprehending the mechanical properties of the tissue at the surgical site. Understanding the mechanical behavior of the medulla oblongata tissue is instrumental for precisely determining the remote surgery implementation site. Additionally, exploring this tissue's response under electric fields can inform the creation of electrical stimulation therapy regimens. This could potentially reduce the extent of medulla oblongata tissue damage from mechanical compression. Various types of pulsed electric fields were integrated into a custom-built indentation device for this study. Experimental findings suggested that applying pulsed electric fields amplified the shear modulus of the medulla oblongata tissue. In the electric field, the elasticity and viscosity of the tissue increased. The most significant influence was noted from the low-frequency pulsed electric field, while the burst pulsed electric field had a minimal impact. At the microstructural scale, the application of an electric field led to the concentration of myelin in areas distant from the surface layer in the medulla oblongata, and the orderly structure of proteoglycans became disordered. The alterations observed in the myelin and proteoglycans under an electric field were considered to be the fundamental causes of the changes in the mechanical behavior of the medulla oblongata tissue. Moreover, cell polarization and extracellular matrix cavitation were observed, with transmission electron microscopy results pointing to laminar separation within the myelin at the ultrastructure scale. This study thoroughly explored the impact of electric field application on the mechanical behavior and microstructure of the medulla oblongata tissue, delving into the underlying mechanisms. This investigation delved into the changes and mechanisms in the mechanical behavior and microstructure of medulla oblongata tissue under the influence of electric fields. Furthermore, this study could serve as a reference for the development of electrical stimulation regimens in the central nervous system. The acquired mechanical behavior data could provide valuable baseline information to aid in the evolution of remote surgery techniques involving the medulla oblongata tissue.

An uncertainty-based quality evaluation tool for nanoindentation systems

Instrumented Indentation Test (IIT) is a nonconventional mechanical tests allowing multi-scale mechanical characterisation. It is employed for research and quality control in strategic manufacturing fields for developing edge technologies. The state-of-the-art lacks a robust methodology to assess quality of indentations and benchmark indentation devices. This is limiting the application of IIT for specifying and verifying tolerances. This work proposes an uncertainty-based quality evaluation tool for IIT. A non-parametric uncertainty evaluation of calibration contribution is proposed. The method shows the statistical significance of indentation sets modelled by the bootstrap samples. The uncertainty is then propagated according to the law of uncertainty propagation for the evaluation of mechanical characteristics. The methodology is applied to five case studies. Results show that the uncertainty evaluation model can achieve robust and sensitive quantification of the indentation results and system quality, thus providing a useful practical tool for industrial and academic practitioners within a metrological framework.

Mechanical behavior and microstructure of porcine brain tissues under pulsed electric fields.

Pulsed electric fields are extensively utilized in clinical treatments, such as subthalamic deep brain stimulation, where electric field loading is in direct contact with brain tissue. However, the alterations in brain tissue's mechanical properties and microstructure due to changes in electric field parameters have not received adequate attention. In this study, the mechanical properties and microstructure of the brain tissue under pulsed electric fields were focused on. Herein, a custom indentation device was equipped with a module for electric field loading. Parameters such as pulse amplitude and frequency were adjusted. The results demonstrated that following an indentation process lasting 5s and reaching a depth of 1000 μm, and a relaxation process of 175s, the average shear modulus of brain tissue was reduced, and viscosity decreased. At the same amplitude, high-frequency pulsed electric fields had a smaller effect on brain tissue than low-frequency ones. Furthermore, pulsed electric fields induced cell polarization and reduced the proteoglycan concentration in brain tissue. As pulse frequency increased, cell polarization diminished, and proteoglycan concentration decreased significantly. High-frequency pulsed electric fields applied to brain tissue were found to reduce impedance fluctuation amplitude. This study revealed the effect of pulsed electric fields on the mechanical properties and microstructure of ex vivo brain tissue, providing essential information to promote the advancement of brain tissue electrotherapy in clinical settings.

Development of a sensor layout for a dynamic indentation device

Issues related to the design of a dynamic indentation sensor are presented in this paper. The use of a magnetic induction method for recording the motion parameters of a striker with a differential circuit of inductors is proposed. A prototype of the primary transducer and a sensor model with a new mechanism for the striker reset system are developed.

Effect of ultrasonic vibration on the deformation through indentation test and molecular dynamics simulation

An ultrasonic vibration-assisted indentation device is utilized to implement indentation tests, performed with a spherical indenter under static load and superimposed ultrasonic vibration excitation pressing into the sample to study the volume effect of ultrasonic vibration. The loading forces during the test are acquired by a Kistler force sensor. An indentation molecular dynamics model (IMDM) and an ultrasonic vibration-assisted indentation molecular dynamics model (UIMDM) are developed to study ultrasonic vibration on the microstructure evolution qualitatively. The test results show differences in the effects of ultrasonic vibration on materials with distinct microstructures, where a 17.2% reduction in loading force is observed for the aluminum sample and almost no change for resin. The molecular dynamics results indicate that ultrasonic vibrations do not affect the total potential energy of the model during the elastic deformation stage but increase the total potential energy of the model in the plastic deformation stage, attributed to the absorption of the ultrasonic vibration energy by the generation of dislocations. Simultaneously, ultrasonic vibration reduces the resistance to dislocation motion, the Peierls-Nabarro force, and increases the von Mises stress within the model, the driving force for dislocation motion, thus reducing the loading force required for plastic deformation.

A MECHANICAL APPROACH FOR THE ASSESSMENT OF COMPARTMENT SYNDROME

In this work, we propose a new quantitative way of evaluating acute compartment syndrome (ACS) by dynamic mechanical assessment of soft tissue changes. First, we have developed an animal model of ACS to replicate the physiological changes during the condition. Secondly, we have developed a mechanical assessment tool for quantitative pre-clinical assessment of ACS. Our hand-held indentation device provides an accurate method for investigations into the local dynamic mechanical properties of soft tissue and for in-situ non-invasive assessment and monitoring of ACS.Our compartment syndrome model was developed on the cranial tibial and the peroneus tertius muscles of a pig's leg (postmortem). The compartment syndrome pressure values were obtained by injecting blood from the bone through the muscle.To enable ACS assessment by a hand-held indentation device we combined three main components: a load cell, a linear actuator and a 3-axis accelerometer. Dynamic tests were performed at a frequency of 0.5 Hz and by applying an amplitude of 0.5 mm.Another method used to observe the differences in the mechanical properties inside the leg was a 3D Digital Image Correlation (3D-DIC). Videos were taken from two different positions of the pig's leg at different pressure values: 0 mmHg, 15 mmHg and 40 mmHg. Two strains along the x axis (Exx) and y axis (Eyy) were measured.Between the two pressure cases (15 mmHg and 40 mmHg) a clear deformation of the model is visible. In fact, the bigger the pressure, the more visible the increase in strain is.In our animal model, local muscle pressures reached values higher than 40 mmHg, which correlate with observed human physiology in ACS. In our presentation we will share our dynamic indentation results on this model to demonstrate the sensitivity of our measurement techniques.Compartment syndrome is recognised as needing improved clinical management tools. Our approach provides both a model that reflects physiological behaviour of ACS, and a method for in-situ non-invasive assessment and monitoring.

Effects of Different Types of Electric Fields on Mechanical Properties and Microstructure of Ex Vivo Porcine Brain Tissues.

Electrotherapy plays a crucial role in regulating neuronal activity. Nevertheless, the relevant therapeutic mechanisms are still unclear; thus, the effects of electric fields on brain tissue's mechanical properties and microstructure need to be explored. In this study, focusing on the changes in mechanical properties and microstructure of ex vivo porcine brain tissues under different types of electric fields, directional and alternating electric fields (frequencies of 5, 20, 50, and 80 Hz, respectively) integrate with a custom-designed indentation device. The experimental results showed that for the ex vivo brain tissue, the directional electric field (DEF) can reduce the elastic properties of brain tissue. Simultaneously, the DEF can increase the cell spacing and reduce the proteoglycan content. The transmission electron microscope (TEM) analysis observed that the DEF can reduce the integrity of the plasma membrane, the endoplasmic reticulum's stress response, and the myelin lamella's separation. The alternating electric field (AEF) can accelerate the stress relaxation process of brain tissue and change the time-dependent mechanical properties of brain tissue. Meanwhile, with the increase in frequency, the cell spacing decreased, and the proteoglycan content gradually approached the control group without electric fields. TEM analysis observed that with the increase in frequency, the integrity of the plasma membrane increases, and the separation of the myelin lamella gradually disappears. Understanding the changes in the mechanical properties and microstructure of brain tissue under AEF and DEF enables a preliminary exploration of the therapeutic mechanism of electrotherapy. Simultaneously, the essential data was provided to support the development of embedded electrodes. In addition, the ex vivo experiments build a solid foundation for future in vivo experiments.

A minimized and efficient low temperature loading device for indentation.

A minimized and efficient low temperature loading device cooling with Peltier coolers for indentation test is developed. Both specimen and indentation tip are immersed in 50% methanol-water solution, totally eliminating the contact thermal drift problem. Low temperature indentation tests down to 253.8K can be realized within 10min. The size of the device is miniaturized within 50 × 40 × 30mm3, and no vacuum environment is required. Monocrystalline copper is tested to perform the feasibility of the device. Based on the simple structure and stable experimental effect, the developed device can be integrated into various types of current indentation devices to attach low temperature testing ability.

Investigation on the sensitivity of indentation devices for detection of fatigue loading induced damage in bovine cortical bone

Daily physiological activities subject our skeletal system to cyclic loading with varying frequencies and magnitudes. These loadings interact with the microstructure of bone and create microdamage, which can cause stress-induced injuries if not repaired on the time. The early detection is required to prevent the complications associated with these fractures. In the present study, to examine fatigue loading-induced damage in cortical bone, the sensitivity of four different indentation devices was investigated. For this, cortical bone samples were fatigued in four-point bending configuration at 0.5 Hz, 2 Hz and 4 Hz frequencies. Following the fatigue loading, cyclic reference point indentation (cRPI), impact reference point indentation (iRPI), Vickers microhardness and nanoindentation tests were performed on the bone samples. Results show that indentation devices are sensitive to detect fatigue loading induced damage only in 0.5 Hz group samples on compressive region. On the other hand, the sensitivity of indentation devices for tensile stress-induced damage is not clear. Also, histological examination of fatigued bone samples shows a significant increase in the crack density and crack length with fatigue loading only for the 0.5 Hz group samples. The present study provides insight into the sensitivity of different indentation devices to fatigue loading induced damage, which could be helpful in the development of new devices for the early diagnosis of stress induced injuries.

Corneal Stiffness and Modulus of Normal-Tension Glaucoma in Chinese

To assess and compare the corneal biomechanics of normal-tension glaucoma (NTG), high-tension glaucoma (HTG), and normal controls based on stiffness and modulus. The correlations among central corneal thickness (CCT), visual field, retinal nerve fiber layer (RNFL) thickness, and corneal biomechanics in glaucoma eyes were also evaluated. A prospective, cross-sectional, comparative study. This study included 334 eyes of 108 NTG patients, 113 HTG patients, and 113 control subjects at Zhongshan Ophthalmic Center, Sun Yat-Sen University. Corneal biomechanics were evaluated using a corneal indentation device (CID) and corneal visualization Scheimpflug technology (Corvis ST). Visual field and RNFL thickness were obtained using standard automated perimetry and spectral-domain optical coherence tomography. One-way analyses of variance with Bonferroni post hoc tests and a multivariable linear regression analysis with adjustment were conducted. Correlations among corneal biomechanical parameters, CCT, visual field, and RNFL thickness were analyzed. The corneal stiffness of the NTG patients (71.0 ± 10.9 N/m) was significantly lower than that of the HTG patients (77.3 ± 15.6 N/m; P=.001) and the CCT- and IOP-matched normal controls (75.6 ± 11.0 N/m; P=.023). The patients in the NTG group had lower corneal stiffness than those in the control group (β=-4.88, 95% CI -9.002, -0.758; P=.020) after adjusting for confounders. Stiffness was positively correlated with CCT in the NTG group (P=.028) but not in the HTG group (P= .509). There was no significant correlation (P > .05) between corneal biomechanics, visual field, or RNFL thickness. The corneas of NTG patients were softer than those of HTG patients and controls, as assessed by CID, which were associated with thinner CCT. These might suggest different ocular biomechanical properties in NTG and HTG.

Investigating the effects of activation state and location on lower limb tissue stiffness

Lower limb tissue stiffness is contingent on various factors, including location, tissue composition, loading rates, and the geometry of the indenting object. Previous studies demonstrated that tissue stiffness varies greatly between individuals and between locations on an individual. Additionally, some studies have shown that activation of underlying muscle tissue increases bulk soft tissue stiffness. Yet, few studies have simultaneously considered both location and activation; this could be particularly important for measuring and predicting the function of devices such as prostheses and exoskeletons that interact with limbs at various locations during dynamic movement. In the present study, a custom handheld indentation device was used to explore changes in bulk leg tissue stiffness at rest and during isometric contractions. The indentation force-displacement curves were modelled using a Hertz model. At each level of activation (active/inactive), the shank had dramatically (∼150%) greater tissue stiffness than the thigh (p < 0.001). However, results suggested location independence for stiffness ratio (active/inactive, p = 0.42); for either location, stiffness was approximately 2x greater for active vs inactive muscle. These results should be considered during the development of biomechanical models to simulate human tissue indentation stiffness across a range of activation states and locations.

Measurement of soft tissue deformation at discomfort and pain threshold in different regions of the head

Understanding of product-soft tissue interface and related discomfort is essential while designing wearable devices. Although pressure thresholds at the perception of discomfort and pain have been measured in the past, associated tissue deformation is yet to be studied. This data can provide a holistic understanding of user discomfort and be a valuable reference for ergonomic product design. Hence, in the current study, tissue deformation at discomfort and pain threshold was measured using an ultrasound indentation device at 18 landmarks for 83 Chinese adults on the head and face. Results show that deformation was higher in the facial region than the scalp and forehead, with maximum deformation in the cheek area and minimum in the forehead region for both thresholds. Also, for most landmarks, the tissue deformation data showed no significant relationship with age and Body Mass Index (BMI). Nearly half of the landmarks exhibited significant gender-based differences. Overall, the measured data showed acceptable within-session and between-session reliability. Practitioner Summary: In this study, tissue deformation was measured in different head regions for discomfort and pain thresholds, and corresponding deformation maps were developed. Measured tissue deformation data showed no significant relationship with BMI and age. This data can be a useful reference in the design, testing, and evaluation of headgears.

A Novel Indentation Assessment to Measure Corneal Biomechanical Properties in Glaucoma and Ocular Hypertension.

PurposeTo evaluate the ability of the new in vivo corneal indentation device (CID) to measure corneal biomechanical properties.Methods and ResultsIn total, 186 eyes from 46 healthy subjects, 107 patients with primary open-angle glaucoma, and 33 patients with ocular hypertension were enrolled in a cross-sectional study. Measurements were performed using corneal visualization Scheimpflug technology (Corvis ST) and the CID. The deformation amplitude (DA), inward applanation time, inward applanation velocity (A1V), outward applanation time (A2T), outward applanation velocity (A2V), highest concavity time, DA ratio, max inverse radius (MIR), integrated radius, and stiffness parameter A1 were included as Corvis ST parameters, and stiffness and modulus were included as CID parameters. Associations between the Corvis ST and CID parameters and correlations between central corneal thickness and corneal biomechanical parameters were analyzed. The stiffness was significantly correlated with all the Corvis ST parameters (P < 0.05). The modulus was significantly correlated with the DA, A1V, A2T, A2V, highest concavity time, and MIR (P < 0.05). The DA, inward applanation time, A1V, A2T, A2V, DA ratio, MIR, integrated radius, and stiffness parameter A1 values and both CID-derived values were significantly correlated with central corneal thickness (P < 0.05).ConclusionsParameters derived from the CID and Corvis ST demonstrated agreement in the measurement of corneal biomechanical properties. The stiffness and modulus can characterize in vivo corneal biomechanical properties.Translational RelevanceAgreeing with the Corvis ST regarding the assessment of corneal biomechanical properties, the CID can be a novel clinical tool for biomechanical evaluation of the cornea.

Evaluation of Adhesion Properties of Hard Coatings by Means of Indentation and Acoustic Emission

In general, the mechanical properties of hard thin coatings are investigated using indentation methods. Material characteristics of hard coatings, such as elastic modulus and hardness, are evaluated by means of nanoindentation and an appropriate evaluation methodology. The most popular method used to obtain the coating properties required using nanoindentation is the evaluation based on the Oliver and Pharr methodology. Adhesion and wear properties can be calculated using these data. In this study, we used a novel method to evaluate the wear and adhesion of coatings. A special measuring device combined with static indentation and acoustic emission signal detection was developed to evaluate the adhesion of coatings. The device consists of a macrohardness instrumental indentation device equipped with an acoustic emission measuring gauge. It was used to investigate crack formation and adhesion of coatings deposited on different substrates using acoustic emissions data. The results using both the existing and novel methods were compared and evaluated.

Dynamic Hardness of MCrAlY Abradable Seal Coating

The purpose of this investigation is to study the dynamic hardness of MCrAlY abradable coatings under different strain rates. A dynamic indentation device based on the split Hopkinson pressure bar system (SHPB) was used. The results show that the hardness of MCrAlY coating increased with the increase of the strain rate, which has a positive strain rate effect. In addition, the difference of the static hardness of MCrAlY coating prepared by HVOF and LPPS was only 4%, while the difference in dynamic hardness was 16%.

Corrosion inhibition characteristics of multilayer Si-DLC, phosphating and anodizing coatings deposited on 2024 Al alloy: A comparative study

The corrosion protection characteristics of anodizing zinc phosphating conversion coatings (ZPC) and Si-DLC multilayer coatings were evaluated on 2024-T3 aluminum alloy. X-ray diffraction (XRD), field emission scanning electronic microscopy (FE-SEM) attached with energy-dispersive X-ray spectroscopy unit (EDS), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS) and Nano Indenter (G200) device were used for characterizing the surface of coatings. Different electrochemical techniques were employed for investigating the corrosion properties of the different coatings. The results revealed that the Si-DLC coating provides the highest corrosion protection compared to the other coatings. Moreover, the morphologies of coatings after 30 days immersed in 3.5% wt. NaCl indicated that the Si-DLC and phosphated coatings did not suffer from pitting, while the anodized sample exhibited selective corrosion.

Characterizing Viscoelastic Property of Soft Tissue Over the Hip as a Risk Factor of Pressure Ulcer

Background: A pressure ulcer is common in soft tissue over the greater trochanter (GT) in side-lying position, and sustained tissue deformation induced by the prolonged external force is a primary cause, which can be discussed with soft tissues’ viscoelastic properties (i.e., stress relaxation, creep response). Objects: Using an automated hand-held indentation device, we measured the viscoelastic properties of soft tissue over the hip area, in order to examine how the properties are affected by site with respect to the GT. Methods: Twenty participants (15 males and 5 females) who aged from 21 to 32 were participated. An automated hand-held indentation device was used to measure the stress relaxation time and creep response. Trials were acquired for three different locations with respect to the GT (i.e., right over the GT, 6 cm anterior or posterior to the GT). For each location, five trials were acquired and averaged for data analyses. Results: Soft tissues’ stress relaxation time and creep response were associated with site (F = 23.98, p < 0.005; F = 24.09, p < 0.005; respectively). The stress relaxation time was greatest at posterior gluteal region (19.22 ± 2.49 ms), and followed by anterior region (15.39 ± 2.47 ms) and right over the GT (14.40 ± 3.18 ms). Similarly, creep response was greatest at posterior gluteal region (1.16 ± 0.14), and followed by anterior region (0.95 ± 0.14) and right over the GT (0.89 ± 0.18). Conclusion: Our results showed that the stress relaxation and creep were greatest at the posterior gluteal region and least at right over the GT, indicating that the gluteal soft tissue is more protective to the prolonged external force, when compared to the trochanteric soft tissue. The results suggest that a risk of pressure ulcer over the GT may decrease with slightly posteriorly rotated side-lying position.