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Background
To assess the in-field walking mechanics during downhill hiking of patients with total knee arthroplasty five to 14 months after surgery and an age-matched healthy control group and relate them to the knee flexor and extensor muscle strength.
Methods
Participants walked on a predetermined hiking trail at a self-selected, comfortable pace wearing an inertial sensor system for recording the whole-body 3D kinematics. Sagittal plane hip, knee, and ankle joint angles were evaluated over the gait cycle at level walking and two different negative slopes. The concentric and eccentric lower extremity muscle strength of the knee flexors and extensors isokinetically at 50 and 120°/s were measured.
Findings
Less knee flexion angles during stance have been measured in patients in the operated limb compared to healthy controls in all conditions (level walking, moderate downhill, steep downhill). The differences increased with steepness. Muscle strength was lower in patients for both muscle groups and all measured conditions. The functional hamstrings to quadriceps ratio at 120°/sec correlated with knee angle during level and downhill walking at the moderate slope in patients, showing higher ratios with lower peak knee flexion angles.
Interpretation
The study shows that even if rehabilitation has been completed successfully and complication-free, five to 14 months after surgery, the muscular condition was still insufficient to display a normal gait pattern during downhill hiking. The muscle balance between quadriceps and hamstring muscles seems related to the persistence of a stiff knee gait pattern after knee arthroplasty. LoE: III.
Hintergrund
In diesem Artikel wird ein Überblick und Vergleich der am häufigsten verwendeten zementierten Hüftschäfte, gruppiert in die verschiedenen Schafttypen und Zementmanteldicken, gegeben, um zu sehen, welche Kombination gut abschneidet.
Methodik
Aus dem Endoprothesenregister Deutschland wurden die Revisionsraten zementierter Schaftarten kategorisiert und die Revisionsraten von 3 und 5 Jahren erfasst und analysiert. Für die Recherche lag die Konzentration auf den Schäften Exeter, C‑Stem, MS-30, Excia, Bicontact, Charnley, Müller Geradschaft, Twinsys, Corail, Avenir, Quadra und dem Lubinus SP II. Ein wichtiger Aspekt lag darin, welcher Schaft favorisiert implantiert wird und welche Zementiertechnik in Hinblick auf die geplante Zementmanteldicke angewendet wird. Um einen Trend in der zementierten Hüftendoprothetik herauszufinden, wurden zusätzlich die Daten des dänischen, schwedischen, norwegischen, schweizerischen, neuseeländischen, englischen und australischen Endoprothesenregister verglichen.
Ergebnisse und Schlussfolgerung
Die meisten Länder nutzen zementierte Prothesen nach dem Kraftschlussprinzip (Exeter, MS30, C‑Stem etc.) oder dem Formschlussprinzip (Charnley, Excia, Bicontact), welche mit einer Zementmanteldicke von 2–4 mm implantiert werden. Jedoch hat sich in Deutschland und der Schweiz ein Trend zur Line-to-Line-Technik, mit einer geplanten Zementmanteldicke von 1 mm (Twinsys, Corail, Avenir, Quadra) aufgezeigt, dem Prinzip der Müller-Geradschaft-Prothese und der Kerboul-Charnley-Prothese folgend, auch wenn diese an sich als „french paradoxon“ postuliert werden. In den EPRD-5-Jahres-Ergebnissen scheinen die neueren Line-to-Line-Prothesen etwas schlechter abzuschneiden. Die besten Ergebnisse erzielt der „MS 30“ in Deutschland und der „Exeter“ in England. Hierbei handelt es sich um polierte Geradschäfte mit Zentraliser und Subsidence-Raum an der Spitze mit einem 2–4 mm Zementmantel in guter Zementiertechnik.
Injury prevention is essential in running due to the risk of overuse injury development. Tailoring running shoes to individual needs may be a promising strategy to reduce this risk. Novel manufacturing processes allow the production of individualised running shoes that incorporate features that meet individual biomechanical and experiential needs. However, specific ways to individualise footwear to reduce injury risk are poorly understood. Therefore, this scoping review provides an overview of (1) footwear design features that have the potential for individualisation; and (2) the literature on the differential responses to footwear design features between selected groups of individuals. These purposes focus exclusively on reducing the risk of overuse injuries. We included studies in the English language on adults that analysed: (1) potential interaction effects between footwear design features and subgroups of runners or covariates (e.g., age, sex) for running-related biomechanical risk factors or injury incidences; (2) footwear comfort perception for a systematically modified footwear design feature. Most of the included articles (n = 107) analysed male runners. Female runners may be more susceptible to footwear-induced changes and overuse injury development; future research should target more heterogonous sampling. Several footwear design features (e.g., midsole characteristics, upper, outsole profile) show potential for individualisation. However, the literature addressing individualised footwear solutions and the potential to reduce biomechanical risk factors is limited. Future studies should leverage more extensive data collections considering relevant covariates and subgroups while systematically modifying isolated footwear design features to inform footwear individualisation.
In this paper, the J-integral is derived for temperature-dependent elastic–plastic materials described by incremental plasticity. It is implemented using the equivalent domain integral method for assessment of three-dimensional cracks based on results of finite-element calculations. The J-integral considers contributions from inhomogeneous temperature fields and temperature-dependent elastic and plastic material properties as well as from gradients in the plastic strains and the hardening variables. Different energy densities are considered, the Helmholtz free energy and the stress-working density, providing a physical meaning of the J-integral as a fracture criteria for crack growth. Results obtained for a plate with two different crack configurations each loaded by a cool-down thermal shock show domain-independence of the incremental J-integral for different energy densities even for high temperature gradients and significant temperature-dependence of the yield stress and the hardening exponent in the presence of large scale yielding. Hence, the derived J-integral is an appropriate parameter for the assessment of cracks in thermomechanically loaded components.
Background
Internal tibial loading is influenced by modifiable factors with implications for the risk of stress injury. Runners encounter varied surface steepness (gradients) when running outdoors and may adapt their speed according to the gradient. This study aimed to quantify tibial bending moments and stress at the anterior and posterior peripheries when running at different speeds on surfaces of different gradients.
Methods
Twenty recreational runners ran on a treadmill at 3 different speeds (2.5 m/s, 3.0 m/s, and 3.5 m/s) and gradients (level: 0%; uphill: +5%, +10%, and +15%; downhill: –5%, –10%, and –15%). Force and marker data were collected synchronously throughout. Bending moments were estimated at the distal third centroid of the tibia about the medial–lateral axis by ensuring static equilibrium at each 1% of stance. Stress was derived from bending moments at the anterior and posterior peripheries by modeling the tibia as a hollow ellipse. Two-way repeated-measures analysis of variance were conducted using both functional and discrete statistical analyses.
Results
There were significant main effects for running speed and gradient on peak bending moments and peak anterior and posterior stress. Higher running speeds resulted in greater tibial loading. Running uphill at +10% and +15% resulted in greater tibial loading than level running. Running downhill at –10% and –15% resulted in reduced tibial loading compared to level running. There was no difference between +5% or –5% and level running.
Conclusion
Running at faster speeds and uphill on gradients ≥+10% increased internal tibial loading, whereas slower running and downhill running on gradients ≥–10% reduced internal loading. Adapting running speed according to the gradient could be a protective mechanism, providing runners with a strategy to minimize the risk of tibial stress injuries.
Footwear plays a critical role in our daily lives, affecting our performance, health and overall well-being. Well-designed footwear can provide protection, comfort and improved foot functionality, while poorly designed footwear can lead to mobility problems and declines in physical activity. The overall goal of footwear research is to provide a scientific basis for professionals in the field to provide an optimal footwear solution for a given person, for a given task, in a given environment, while using sustainable manufacturing processes. This article suggests potential directions for future research with a focus on athletic footwear biomechanics. Directions include the evidence-based individualisation of footwear, the interaction between design and prolonged use, and improving the sustainability of footwear. The authors also provide a speculative outlook on methodological developments that may provide greater insight into these areas. These developments may include: (1) the use of larger scale, real-world and representative data, (2) the use of 3D printing to create experimental footwear, (3) the advancement of in silico research methods, and (4) furthering multidisciplinary collaboration. If successfully applied in the future, footwear research will contribute to active and healthy lifestyles across the lifespan.
Bewegungsanalysesysteme in der Forschung und für niedergelassene Orthopädinnen und Orthopäden
(2023)
Hintergrund
Komplexe biomechanische Bewegungsanalysen können für eine Vielzahl orthopädischer Fragestellungen wichtige Informationen liefern. Bei der Beschaffung von Bewegungsanalysesystemen sind neben den klassischen Messgütekriterien (Validität, Reliabilität, Objektivität) auch räumliche und zeitliche Rahmenbedingungen sowie Anforderungen an die Qualifikation des Messpersonals zu berücksichtigen.
Anwendung
In der komplexen Bewegungsanalyse werden Systeme zur Bestimmung der Kinematik, der Kinetik und der Muskelaktivität (Elektromyographie) eingesetzt. Der vorliegende Artikel gibt einen Überblick über Methoden der komplexen biomechanischen Bewegungsanalyse für den Einsatz in der orthopädischen Forschung oder in der individuellen Patientenversorgung. Neben dem Einsatz zur reinen Bewegungsanalyse wird auch der Einsatz von Bewegungsanalyseverfahren im Bereich des Biofeedbacktrainings diskutiert.
Beschaffung
Für die konkrete Anschaffung von Bewegungsanalysesystemen empfiehlt sich die Kontaktaufnahme mit Fachgesellschaften (z. B. Deutsche Gesellschaft für Biomechanik), Hochschulen und Universitäten mit vorhandenen Bewegungsanalyseeinrichtungen oder Vertriebsfirmen im Bereich der Biomechanik.
Im Automobilbau bietet der Einsatz der Multimaterialbauweise ein signifikantes Potenzial zur Gewichtsreduktion. Zugleich erfordert diese Bauweise eine große Anzahl von Fügeverfahren für die Verbindung der unterschiedlichen Werkstoffe und Werkstoffklassen. Dabei muss eine Vielzahl an konstruktiven und materialseitigen Anforderungen berücksichtigt werden. Um in diesem Auswahlprozess den Aspekt des Leichtbaus beim Fügeverfahren selbst systematisch zu integrieren, wurde eine Methodik entwickelt, welche die Fügeverfahren im Hinblick auf ihr jeweiliges Leichtbaupotenzial bewertet.
Human interaction frequently includes decision-making processes during which interactants call on verbal and non-verbal resources to manage the flow of interaction. In 2017, Stevanovic et al. carried out pioneering work, analyzing the unfolding of moment-by-moment dynamics by investigating the behavioral matching during search and decision-making phases. By studying the similarities in the participant's body sway during a conversation task in Finnish, the authors showed higher behavioral matching during decision phases than during search phases. The purpose of this research was to investigate the whole-body sway and its coordination during joint search and decision-making phases as a replication of the study by Stevanovic et al. (2017) but based on a German population. Overall, 12 dyads participated in this study and were asked to decide on 8 adjectives, starting with a pre-defined letter, to describe a fictional character. During this joint-decision task (duration: 206.46 ± 116.08 s), body sway of both interactants was measured using a 3D motion capture system and center of mass (COM) accelerations were computed. Matching of body sway was calculated using a windowed cross correlation (WCC) of the COM accelerations. A total of 101 search and 101 decision phases were identified for the 12 dyads. Significant higher COM accelerations (5.4*10−3 vs. 3.7*10−3 mm/s2, p < 0.001) and WCC coefficients (0.47 vs. 0.45, p = 0.043) were found during decision-making phases than during search phases. The results suggest that body sway is one of the resources humans use to communicate the arrival at a joint decision. These findings contribute to a better understanding of interpersonal coordination from a human movement science perspective.
Given the looming threats of climate change and the rapid worldwide urbanization, it is a necessity to prioritize the transition towards a carbon-free built environment. This research study provides a holistic digital methodology for parametric design of urban residential buildings with regard to the Mediterranean semi-arid climate zone of Morocco in the early design phase. The morphological parameters of the urban residential buildings, namely the buildings’ typology, the distance between buildings, the urban grid’s orientation, and the window-towall ratio, are evaluated in order to identify the key combinations of passive and active solar design strategies that determine the high energy performing configurations, based on the introduced Energy Performance Index (EPI), which is the ratio between solar BIPV production to maximum available installed BIPV capacity and the normalized thermal energy needs. Through an automated processing of 2187 iterations via Grasshopper, we simulate daylight autonomy, indoor thermal comfort and solar rooftop photovoltaic and building integrated photovoltaic (BIPV) energy potential. Then, we analyze the conflicting objectives of energy efficiency measures, active solar design strategies, and indoor visual comfort in the decision-making process that supports our goal of getting closer to net zero urban residential buildings. The digital workflow showed interesting trends in reaching a balanced equilibrium between performance metrics influenced by the contrasting impact of solar exposure on indoor daylight autonomy and thermal energy demand. Furthermore, the study’s findings indicate that it is possible to achieve an annual load match exceeding 66,56 % while simultaneously ensuring an acceptable visual indoor comfort (sDA higher than 0.4). The findings also highlight the important role of the BIPV system in shifting towards the net zero energy goal, by contributing up to 30 % of the overall solar energy output and covering up to 20 % of the yearly self-consumption. Moreover, the energy balance evaluation on an hourly basis indicates that BIPV system notably enhances the daily load cover factor by up to 5.5 %, particularly in the case of slab SN typology, throughout the different seasons. Graphical representations of the yearly, monthly and hourly load matches and the hourly energy balance of the best performing configurations provide a thorough understanding of the potential evolution of the urban energy system over time as a result of the gradual integration of active solar electricity production.