Rôle des informations proprioceptives dans l’équilibre à la marche chez les personnes en santé et hémiparétiques

L'utilisation des informations proprioceptives pour le contrôle de l’équilibre à la marche est encore mal comprise chez les sujets en santé ou hémiparétiques suite à un accident vasculaire cérébral. Le but de cette étude était d’évaluer le rôle des informations proprioceptives dans le maintien de l'équilibre à la marche chez les patients en santé et hémiparétiques. Une analyse de mouvement en trois dimensions a été faite chez treize participants en santé et six hémiparétiques qui marchaient sur un tapis roulant instrumenté pour déterminer leur difficulté à maintenir l’équilibre postural et dynamique, évaluée respectivement par les forces stabilisante et déstabilisante. Des vibrations étaient appliquées en continu ou pendant la phase d’appui sur les muscles postérieurs du cou et sur le triceps sural du côté non-dominant/parétique. La vibration continue ou à l’appui du triceps sural a diminué, chez les sujets en santé, la difficulté à maintenir l’équilibre dynamique et postural (p< 0,01), avec une position du corps plus en arrière, sans changement des paramètres temporels de marche. L'équilibre et les paramètres temporels de la marche n'étaient pas modifiés significativement par la vibration à la nuque (p>.17). Aucun effet des vibrations n'a été mesuré chez les patients hémiparétiques (p> 0,45). Les informations proprioceptives sont donc bien utilisées lors de la marche, mais leur rôle dépendrait des conditions de marche et des afférences visuelles disponibles. Un changement dans les capacités d’intégration expliquerait l'absence d'effet des vibrations chez les patients hémiparétiques. D’autres études sont nécessaires pour comprendre l’intégration des informations proprioceptives et visuelles dans le contrôle de l’équilibre à la marche.

Étude du contrôle postural quasi-statique et dynamique en position debout des personnes ayant une lésion médullaire incomplète.

L’atteinte sensorimotrice découlant d’une lésion médullaire traumatique affecte la capacité à se tenir debout de façon sécuritaire. Chez les individus ayant une lésion médullaire incomplète, les chutes lors des tâches locomotrices sont fréquentes après la réadaptation, entraînant des blessures qui affectent la participation sociale et la qualité de vie. Une meilleure compréhension du contrôle postural en clinique aiderait à cibler des interventions efficaces à ce niveau. L’objectif général de cette thèse était donc d’étudier le contrôle postural debout lors de tâches variées chez les personnes avec lésion médullaire traumatique en utilisant une approche biomécanique. Les objectifs spécifiques étaient d’étudier divers aspects du contrôle postural en lien avec chacune des tâches et d’identifier les variables prédictives de la stabilité. Vingt-cinq (25) personnes ayant une lésion médullaire traumatique incomplète ont été recrutées. Elles ont été évaluées au laboratoire d’analyse de mouvement lors du maintien de la station debout quasi-statique yeux ouverts et fermés, de l’exécution d’un test des limites de stabilité multidirectionnelles, de la marche naturelle et de l’initiation et l’arrêt de la marche. Des mesures biomécaniques caractérisant le déplacement du centre de pression (COP) ainsi que le modèle du contrôle postural dynamique des forces stabilisantes et déstabilisantes ont été utilisés pour comparer le contrôle postural des patients à celui d’un groupe formé de 33 personnes en santé. Les résultats ont montré une diminution du contrôle postural quasi-statique et dynamique chez les personnes ayant une lésion médullaire comparativement aux personnes en santé. Cette diminution s’accompagnait d’une contribution élevée des informations visuelles à la station debout quasi-statique qui était associée au score du mini BESTest. Le déplacement du COP lors du test des limites de stabilité multidirectionnelle se caractérisait par une difficulté à suivre la direction indiquée. Ce manque de précision causait une augmentation du trajet nécessaire pour atteindre la distance maximale dans chacune des directions. Les résultats au maintien de la station debout quasi-statique et au test des limites de stabilité multidirectionnelle n’étaient pas corrélés. La phase unipodale de la marche des personnes ayant une lésion médullaire différait de celle des personnes en santé par une force stabilisante maximale moindre et une force déstabilisante plus grande alors que l’arrêt de la marche se révélait plus instable que l’initiation de la marche chez les personnes ayant une lésion médullaire. Pour l’ensemble des tâches de marche, la vitesse du COM et la distance entre le COP et la base de support étaient les facteurs explicatifs principaux des forces stabilisantes et déstabilisantes. En somme, les résultats confirment l’impression clinique d’une atteinte générale du contrôle postural debout des personnes ayant une lésion médullaire; ils en précisent les caractéristiques et ciblent les paramètres à considérer dans la rééducation.

Biomechanical force displacement analysis of strength of fixation of tracker holding devices to bone in computer aided joint replacement

Computer aided joint replacement surgery has become very popular during recent years and is being done in increasing numbers all over the world. The accuracy of the system depends to a major extent, on accurate registration and immobility of the tracker attachment devices to the bone. This study was designed to asses the forces needed to displace the tracker attachment devices in the bone simulators. Bone simulators were used to maintain the uniformity of the bone structure during the study. The fixation devices tested were 3mm diameter self drilling, self tapping threaded pin, 4mm diameter self tapping cortical threaded pin, 5mm diameter self tapping cancellous threaded pin and a triplanar fixation device ‘ortholock’ used with three 3mm pins. All the devices were tested for pull out, translational and rotational forces in unicortical and bicortical fixation modes. Also tested was the normal bang strength and forces generated by leaning on the devices. The forces required to produce translation increased with the increasing diameter of the pins. These were 105N, 185N, and 225N for the unicortical fixations and 130N, 200N, 225N for the bicortical fixations for 3mm, 4mm and 5mm diameter pins respectively. The forces required to pull out the pins were 1475N, 1650N, 2050N for the unicortical, 1020N, 3044N and 3042N for the bicortical fixated 3mm, 4mm and 5mm diameter pins. The ortholock translational and pull out strength was tested to 900N and 920N respectively and still it did not fail. Rotatory forces required to displace the tracker on pins was to the magnitude of 30N before failure. The ortholock device had rotational forces applied up to 135N and still did not fail. The manual leaning forces and the sudden bang forces generated were of the magnitude of 210N and 150N respectively. The strength of the fixation pins increases with increasing diameter from three to five mm for the translational forces. There is no significant difference in pull out forces of four mm and five mm diameter pins though it is more that the three mm diameter pins. This is because of the failure of material at that stage rather than the fixation device. The rotatory forces required to displace the tracker are very small and much less that that can be produced by the surgeon or assistants in single pins. Although the ortholock device was tested to 135N in rotation without failing, one has to be very careful not to put any forces during the operation on the tracker devices to ensure the accuracy of the procedure.

(-)-CGP12177 increases contractile force through beta1l-adrenoceptors but not through beta3-adrenoceptors in human right atrial myocardium

(-)-CGP12177 is a non-conventional partial agonist that causes modest and transient increases of contractile force in human atrial trabeculae (Kaumann and Molenaar, 2008). These effects are markedly increased and maintained by inhibition of phosphodiesterase PDE3. As verified with recombinant receptors, the cardiostimulant effect of (-)-CGP12177 is mediated through a site at the beta1-adrenoceptor with lower affinity (beta1LAR) compared to the site through which (-)-CGP12177 antagonizes the effects of catecholamines (beta1HAR). However, in a recent report it was proposed that the positive inotropic effects of CGP12177 are mediated through beta3-adrenoceptors (Skeberdis et al 2008). We therefore investigated whether the effects of (-)-CGP12177 on human atrial trabeculae are antagonized by the beta3-adrenoceptor-selective antagonist L-748,337 (1 microM). (-)-CGP12177 (200 nM) caused a stable increase in force which was significantly reduced by the addition of (-)-bupranolol (1 microM), P = 0.002, (basal 4.45 ± 0.78 mN, IBMX (PDE inhibitor) 5.47 ± 1.01 mN, (-)-CGP12177 9.34 ± 1.33 mN, (-)-bupranolol 5.79 ± 1.08 mN, n = 6) but not affected by the addition of L-748,337 (1 microM), P = 0.12, (basal 4.48 ± 1.32 mN, IBMX 7.15 ± 2.28 mN, (-)-CGP12177 12.51 ± 3.71 mN, L-748,337 10.90 ± 3.49 mN, n = 6). Cumulative concentration-effect curves for (-)-CGP12177 were not shifted to the right by L-748,337 (1 microM). The –logEC50M values of (-)-CGP12177 in the absence and presence of L-748,337 were 7.21±0.09 and 7.41±0.13, respectively (data from 25 trabeculae from 8 patients, P=0.2) The positive inotropic effects of (-)-CGP12177 (IBMX present) were not antagonized by L-748,337 but were blunted by (-)-bupranolol (1 microM). The results rule out an involvement of beta3-adrenoceptors in the positive inotropic effects (-)-CGP12177 in human right atrial myocardium and are consistent with mediation through beta1LAR. Kaumann A and Molenaar P (2008) Pharmacol Ther 118, 303-336 Skeberdis VA et al (2008) J Clin Invest, 118, 3219-3227

The well-being of older job-seekers : implications for the labour force participation agenda

Throughout the developed world demographic trends and their forecast consequences are attracting the attention of governments, academics, think tanks and the popular press alike. Population aging, in particular, is the focus of many and has generated extensive debate. Approaches commonly advocated in the literature include a mix of ‘population', ‘participation’ and ‘productivity’ measures. Immigration and population policy alongside industry reform and related productivity initiatives are also being pursued. Participation, however, remains a key element of the demographic change policy response. Evidence suggests however, that these approaches are unlikely to deliver the necessary labour force volumes. This has prompted a shift in the participation agenda to also include a stronger focus on skilled and experienced older workers. The literature suggests, however, that the current suite of practices are less than effective for the long-term unemployed, previously long-tenured older workers with specialised skills and trade-displaced workers. Adverse health and human capital outcomes often associated with social disadvantage are complicating factors. This reminds of the complexity of the challenge in seeking to deliver social equity to the disadvantaged and suggests a need for an alternative policy architecture. By integrating the three concepts of health capital, human capital and social capital we show how policy has to change if the older age cohorts of jobseekers are to be assisted to remain employable. This review includes an examination of current policy, a consolidation of the literature and original data.

Aging and the force-velocity relationship of muscles

Aging in humans is associated with a loss in neuromuscular function and performance. This is related, in part, to the reduction in muscular strength and power caused by a loss of skeletal muscle mass (sarcopenia) and changes in muscle architecture. Due to these changes, the force-velocity (f-v) relationship of human muscles alters with age. This change has functional implications such as slower walking speeds. Different methods to reverse these changes have been investigated, including traditional resistance training, power training and eccentric (or eccentrically-biased) resistance training. This review will summarise the changes of the f-v relationship with age, the functional implications of these changes and the various methods to reverse or at least partly ameliorate these changes.

Force-controlled automatic microassembly of tissue engineering scaffolds

This paper presents an automated system for 3D assembly of tissue engineering (TE) scaffolds made from biocompatible microscopic building blocks with relatively large fabrication error. It focuses on the pin-into-hole force control developed for this demanding microassembly task. A beam-like gripper with integrated force sensing at a 3 mN resolution with a 500 mN measuring range is designed, and is used to implement an admittance force-controlled insertion using commercial precision stages. Visual-based alignment followed by an insertion is complemented by a haptic exploration strategy using force and position information. The system demonstrates fully automated construction of TE scaffolds with 50 microparts whose dimension error is larger than 5%.

Virtual force feedback teleoperation of the InsectBot using optical flow

This paper proposes the use of optical flow from a moving robot to provide force feedback to an operator’s joystick to facilitate collision free teleoperation. Optical flow is measured by a pair of wide angle cameras on board the vehicle and used to generate a virtual environmental force that is reflected to the user through the joystick, as well as feeding back into the control of the vehicle. We show that the proposed control is dissipative and prevents the vehicle colliding with the environment as well as providing the operator with a natural feel for the remote environment. Experimental results are provided on the InsectBot holonomic vehicle platform.

A new framework for force feedback teleoperation of robotic vehicles based on optical flow

This paper proposes the use of optical flow from a moving robot to provide force feedback to an operator's joystick to facilitate collision free teleoperation. Optic flow is measured by wide angle cameras on board the vehicle and used to generate a virtual environmental force that is reflected to the user through the joystick, as well as feeding back into the control of the vehicle. The coupling between optical flow (velocity) and force is modelled as an impedance - in this case an optical impedance. We show that the proposed control is dissipative and prevents the vehicle colliding with the environment as well as providing the operator with a natural feel for the remote environment. The paper focuses on applications to aerial robotics vehicles, however, the ideas apply directly to other force actuated vehicles such as submersibles or space vehicles, and the authors believe the approach has potential for control of terrestrial vehicles and even teleoperation of manipulators. Experimental results are provided for a simulated aerial robot in a virtual environment controlled by a haptic joystick.

The effect of friction on indenter force and pile-up in numerical simulations of bone nanoindentation

Nanoindentation is a useful technique for probing the mechanical properties of bone, and finite element (FE) modeling of the indentation allows inverse determination of elasto-plastic constitutive properties. However, FE simulations to date have assumed frictionless contact between indenter and bone. The aim of this study was to explore the effect of friction in simulations of bone nanoindentation. Two dimensional axisymmetric FE simulations were performed using a spheroconical indenter of tip radius 0.6m and angle 90°. The coefficient of friction between indenter and bone was varied between 0.0 (frictionless) and 0.3. Isotropic linear elasticity was used in all simulations, with bone elastic modulus E=13.56GPa and Poisson’s ratio =0.3. Plasticity was incorporated using both Drucker-Prager and von Mises yield surfaces. Friction had a modest effect on the predicted force-indentation curve for both von Mises and Drucker-Prager plasticity, reducing maximum indenter displacement by 10% and 20% respectively as friction coefficient was increased from zero to 0.3 (at a maximum indenter force of 5mN). However, friction has a much greater effect on predicted pile-up after indentation, reducing predicted pile-up from 0.27m to 0.11m with a von Mises model, and from 0.09m to 0.02m with Drucker-Prager plasticity. We conclude that it is important to include friction in nanoindentation simulations of bone.

Human atrial beta1L-adrenoceptor but not beta3-adrenoceptor activation increases force and Ca2+ current at physiological temperature

BACKGROUND AND PURPOSE It has been proposed that BRL37344, SR58611 and CGP12177 activate b3-adrenoceptors in human atrium to increase contractility and L-type Ca2+ current (ICa-L). b3-adrenoceptor agonists are potentially beneficial for the treatment of a variety of diseases but concomitant cardiostimulation would be potentially harmful. It has also been proposed that (-)-CGP12177 activates the low affinity binding site of the b1-adrenoceptor in human atrium. We therefore used BRL37344, SR58611 and (-)-CGP12177 with selective b-adrenoceptor subtype antagonists to clarify cardiostimulant b-adrenoceptor subtypes in human atrium. EXPERIMENTAL APPROACH Human right atrium was obtained from patients without heart failure undergoing coronary artery bypass or valve surgery. Cardiomyocytes were prepared to test BRL37344, SR58611 and CGP12177 effects on ICa-L. Contractile effects were determined on right atrial trabeculae. KEY RESULTS BRL37344 increased force which was antagonized by blockade of b1- and b2-adrenoceptors but not by blockade of b3-adrenoceptors with b3-adrenoceptor-selective L-748,337 (1 mM). The b3-adrenoceptor agonist SR58611 (1 nM–10 mM) did not affect atrial force. BRL37344 and SR58611 did not increase ICa-L at 37°C, but did at 24°C which was prevented by L-748,337. (-)-CGP12177 increased force and ICa-L at both 24°C and 37°C which was prevented by (-)-bupranolol (1–10 mM), but not L-748,337. CONCLUSIONS AND IMPLICATIONS We conclude that the inotropic responses to BRL37344 are mediated through b1- and b2-adrenoceptors. The inotropic and ICa-L responses to (-)-CGP12177 are mediated through the low affinity site b1L-adrenoceptor of the b1-adrenoceptor. b3-adrenoceptor-mediated increases in ICa-L are restricted to low temperatures. Human atrial b3-adrenoceptors do not change contractility and ICa-L at physiological temperature.