Loading compliance of static load bearing exercises performed by transfemoral amputees fitted with an osseointegrated implant

Background To date bone-anchored prostheses are used to alleviate the concerns caused by socket suspended prostheses and to improve the quality of life of transfemoral amputees (TFA). Currently, two implants are commercially available (i.e., OPRA (Integrum AB, Sweden), ILP (Orthodynamics GmbH, Germany)). [1-17]The success of the OPRA technique is codetermined by the rehabilitation program. TFA fitted with an osseointegrated implant perform progressive mechanical loading (i.e. static load bearing exercises (LBE)) to facilitate bone remodelling around the implant.[18, 19] Aim This study investigated the trustworthiness of monitoring the load prescribed (LP) during experimental static LBEs using the vertical force provided by a mechanical bathroom scale that is considered a surrogate of the actual load applied. Method Eleven unilateral TFAs fitted with an OPRA implant performed five trials in four loading conditions. The forces and moments on the three axes of the implant were measured directly with an instrumented pylon including a six-channel transducer. The “axial” and “vectorial” comparisons corresponding to the difference between the force applied on the long axis of the fixation and LP as well as the resultant of the three components of the load applied and LP, respectively were analysed Results For each loading condition, Wilcoxon One-Sample Signed Rank Tests were used to investigate if significant differences (p<0.05) could be demonstrated between the force applied on the long axis and LP, and between the resultant of the force and LP. The results demonstrated that the raw axial and vectorial differences were significantly different from zero in all conditions (p<0.05), except for the vectorial difference for the 40 kg loading condition (p=0.182). The raw axial difference was negative for all the participants in every loading condition, except for TFA03 in the 10 kg condition (11.17 N). Discussion & Conclusion This study showed a significant lack of axial compliance. The load applied on the long axis was significantly smaller than LP in every loading condition. This led to a systematic underloading of the long axis of the implant during the proposed experimental LBE. Monitoring the vertical force might be only partially reflective of the actual load applied, particularly on the long axis of the implant.

Association between aneurysm shoulder stress and abdominal aortic aneurysm expansion: A longitudinal follow-up study

Background Aneurysm expansion rate is an important indicator of the potential risk of abdominal aortic aneurysm (AAA) rupture. Stress within the AAA wall is also thought to be a trigger for its rupture. However, the association between aneurysm wall stresses and expansion of AAA is unclear. Methods and Results Forty-four patients with AAAs were included in this longitudinal follow-up study. They were assessed by serial abdominal ultrasonography and computed tomography scans if a critical size was reached or a rapid expansion occurred. Patient-specific 3-dimensional AAA geometries were reconstructed from the follow-up computed tomography images. Structural analysis was performed to calculate the wall stresses of the AAA models at both baseline and final visit. A nonlinear large-strain finite element method was used to compute the wall-stress distribution. The relationship between wall stresses and expansion rate was investigated. Slowly and rapidly expanding aneurysms had comparable baseline maximum diameters (median, 4.35 cm [interquartile range, 4.12 to 5.0 cm] versus 4.6 cm [interquartile range, 4.2 to 5.0 cm]; P=0.32). Rapidly expanding AAAs had significantly higher shoulder stresses than slowly expanding AAAs (median, 300 kPa [interquartile range, 280 to 320 kPa] versus 225 kPa [interquartile range, 211 to 249 kPa]; P=0.0001). A good correlation between shoulder stress at baseline and expansion rate was found (r=0.71; P=0.0001). Conclusion A higher shoulder stress was found to have an association with a rapidly expanding AAA. Therefore, it may be useful for estimating the expansion of AAAs and improve risk stratification of patients with AAAs.

Experimental and numerical investigation of strain-rate-dependent behavior of kangaroo shoulder cartilage

This thesis introduces a new animal model, kangaroo, to biomechanical investigations of shoulder cartilage research. It examines the effect of cartilage structure and constituents on tissue behavior and its adaptation to mechanical loading. In doing so, the study explains the relationship of tissue's functional behaviors to its structure and constituents which has important implications for tissue engineering strategies catering joint specific cartilage tissue generation.

Prevalence and incidence of shoulder and neck dysfunction after neck dissection: A systematic review

Background: Head and neck cancer is a debilitating disease. Not only can the primary tumour cause painful swallowing and speech difficulties, the treatments required to manage it can impact on neck and shoulder musculoskeletal function. In particular, those patients who undergo neck dissection surgery to remove lymph nodes from the neck can acquire accessory nerve injury during the procedure and a resultant loss of shoulder/neck motion, strength and function. Despite changes to surgical techniques that can protect the nerve, patients still report problems post-operatively.

Exercises at Polonies Talmud Torah School

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Time-frequency analysis of human motion during rhythmic exercises

Biomechanical signals due to human movements during exercise are represented in time-frequency domain using Wigner Distribution Function (WDF). Analysis based on WDF reveals instantaneous spectral and power changes during a rhythmic exercise. Investigations were carried out on 11 healthy subjects who performed 5 cycles of sun salutation, with a body-mounted Inertial Measurement Unit (IMU) as a motion sensor. Variance of Instantaneous Frequency (I.F) and Instantaneous Power (I.P) for performance analysis of the subject is estimated using one-way ANOVA model. Results reveal that joint Time-Frequency analysis of biomechanical signals during motion facilitates a better understanding of grace and consistency during rhythmic exercise.

A Novel Fiber Bragg Grating Based Sensing Methodology for Direct Measurement of Surface Strain on Body Muscles during Physical Exercises

The present work proposes a new sensing methodology, which uses Fiber Bragg Gratings (FBGs) to measure in vivo the surface strain and strain rate on calf muscles while performing certain exercises. Two simple exercises, namely ankle dorsi-flexion and ankle plantar-flexion, have been considered and the strain induced on the medial head of the gastrocnemius muscle while performing these exercises has been monitored. The real time strain generated has been recorded and the results are compared with those obtained using a commercial Color Doppler Ultrasound (CDU) system. It is found that the proposed sensing methodology is promising for surface strain measurements in biomechanical applications.

Forming limit investigation of friction stir welded sheets: influence of shoulder diameter and plunge depth

The main aim of the present work is to analyze the influence of shoulder diameter and plunge depth on the formability of friction stir welded sheets. The base material used for welding and forming was AA6061-T6. Formability evaluation was performed through limiting dome height tests. The forming limit curve, FLC (only in the stretching region), thickness distribution, and strain hardening exponent of the weld region were monitored during formability studies. It is found from the work that the forming limit of friction stir welded sheets is better than unwelded sheets. In general, with an increase in shoulder diameter and plunge depth, the forming limit is found to improve considerably. With a decrease in thickness gradient severity and an increase in strain hardening exponent (n) of the weld region, the forming limit is found to increase. The increase in n value of the weld region is believed to occur because of the reduction in dislocation density. The maximum thickness difference is higher in the retreating side, rather than in the advancing side, of the weld. This is due to the differential straining and hardness levels attained by both sides during friction stir welding.

Evaluation of airline exercises prescribed to avoid deep vein thrombosis using fiber Bragg grating sensors

Various leg exercises have been recommended to prevent deep vein thrombosis (DVT), a condition where a blood clot forms in the deep veins, especially during long-haul flights. Accessing the benefit of each of these exercises in avoiding the DVT, which can be fatal, is important in the context of suggesting the correct and the most beneficial exercises. Present work aims at demonstrating the fiber Bragg grating (FBG)-based sensing methodology for measuring surface strains generated on the skin of the calf muscle to evaluate the suggested airline exercises to avoid DVT. As the dataset in the experiment involves multiple subjects performing these exercises, an inertial measurement unit has been used to validate the repetitiveness of each of the exercises. The surface strain on the calf muscle obtained using the FBG sensor, which is a measure of the calf muscle deformation, has been compared against the variation of blood velocity in the femoral vein of the thigh measured using a commercial electronic-phased array color Doppler ultrasound system. Apart from analyzing the effectiveness of suggested exercises, a new exercise which is more effective in terms of strain generated to avoid DVT is proposed and evaluated. (C) 2013 Society of Photo-Optical Instrumentation Engineers (SPIE)

Intermediate Macroeconomics : Self-evaluation exercises

This resource can be particularly helpful to students taking the Intermediate Macroeconomics course, which corresponds to the second year of the current Degree in Economics at the University of the Basque Country UPV/ EHU. The precise content of this resource is a collection of eight chapters of multiple-choice questions. For each question the user is asked to guess which the correct answer is. Finally, the tool will return all the correct answers for the whole test, thereby allowing the user to check the validity of his/her answers. A remarkable feature of the tool is that it has been edited in three versions, for the three languages (Spanish, Basque and English) in which the subject is taught at the UPV/EHU.

Research Question, Study Design and Continuous Research Education and Training Exercises (CREATE) Program.

The clinical research project starts with identifying the optimal research question, one that is ethical, impactful, feasible, scientifically sound, novel, relevant, and interesting. The project continues with the design of the study to answer the research question. Such design should be consistent with ethical and methodological principles, and make optimal use of resources in order to have the best chances of identifying a meaningful answer to the research question. Physicians and other healthcare providers are optimally positioned to identify meaningful research questions the answer to which could make significant impact on healthcare delivery. The typical medical education curriculum, however, lacks solid training in clinical research. We propose CREATE (Continuous Research Education And Training Exercises) as a peer- and group-based, interactive, analytical, customized, and accrediting program with didactic, training, mentoring, administrative, and professional support to enhance clinical research knowledge and skills among healthcare professionals, promote the generation of original research projects, increase the chances of their successful completion and potential for meaningful impact. The key features of the program are successive intra- and inter-group discussions and confrontational thematic challenges among participating peers aimed at capitalizing on the groups' collective knowledge, experience and skills, and combined intellectual processing capabilities to optimize choice of research project elements and stakeholder decision-making.