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At low Reynolds number flows, the effect of inertia becomes negligible and the fluid motion is dominated by the effect of viscous forces. Understanding of the behaviour of low Reynolds number flows underpins the prediction of the motion of microorganisms and particle sedimentation as well as the development of micro-robots that could potentially swim inside the human body to perform targeted drug/cell delivery and non-invasive microsurgery. The work in this thesis focuses on developing an understanding in the mathematical analysis of objects moving at low Reynolds numbers. A boundary element implementation of the Method of regularized Stokeslets (MRS) is applied to analyse the low Reynolds number flow field around an object of simple shape (sphere and cube). It also showed that the results obtained by a boundary element implementation for an unbounded cube, where singularities are presented in the corners of the cube, agrees with more complex solutions methods such as a GBEM and FEM.A methodology for analysing the effect of walls by locating collocation points on the surface of the walls and the object is presented. First at all, this methodology is validated with a boundary element implementation of the method of images for a sphere at different locations. Then, the method is extended when more than one wall is presented. This methodology is applied to predict the velocity filed of a cube moving in a tow tank at low Reynolds numbers for two different cases with a supporting rod similar to an experimental set-up, and without the supporting rod as in the CFD simulations based on the FVM. The results indicate a good match between CFD and the MRS, and an excellent approximation between the MRS and experimental data from PIV measurements. The drag, thrust and torque generated by helices moving at low Reynolds numbers in an unbounded medium is analysed by the resistive force theory, a slender body theory, and a boundary element method of the MRS. The results show that the resistive force theory predict accurately the drag, thrust and torque of moving helices when the resistive force coefficients are calculated from a slender body theory approximation by calculating independently the resistive force coefficients for translation and rotation, because it is observed that the resistive force coefficients depend also of the nature of motion. Moreover, the thrust generated by helices of different pitch angles is analysed calculated by a CFD numerical simulation based on the FVM and a boundary element implementation, an compared with experimental data. The results also show an excellent prediction between the boundary element implementation, the CFD results and the experimental data. Finally, a boundary element implementation of the MRS is applied to predict swimming of a biomimetic swimmer that mimics the motion of E.coli bacteria in an unbounded medium. The results are compared with the propulsive velocity and induced angular velocity measurement by recording the motion of the biomimetic swimmer in a square tank. It is observed that special care needs to be taken when the biomimetic swimmer is modelled inside the tank, as there is an apparent increment in the calculate thrust propulsion which does not represent a real situation of the biometic swimmer which propels by a power supply. However, this increment does not represent the condition of the biomimetic swimmer and a suggested methodology based on the solution from an unbounded case and when the swimmer is moving inside the tank is presented. In addition, the prediction of the free-swimming velocity for the biomimetic swimmer agrees with the results obtained by the MRS when the resistive force coefficients are calculated from a SBT implementation. The results obtained in this work have showed that a boundary element implementation of the MRS produces results comparable with more complex numerical implementations such as GBEM, FEM, FVM, and also an excellent agreement with results obtained from experimentation. Therefore, it is a suitable and easy to apply methodology to analyse the motion of swimmers at low Reynolds numbers, such as the biomimetic swimmer modelled in this work.

The Sit-to-Stand (STS) transition is a voluntary daily activity that consists of rising from a sitting position to a standing position, an activity that is typically performed by a person several times a day. To undertake the activity successfully requires the coordination of the body limbs in order to transfer the body weight between the sitting and standing positions, maintaining the balance, in order to avoid a fall. A biomechanical analysis of the STS transition provides useful information about the motor ability and control strategy of a person and as such, it is commonly employed to assess functional performance, and as an indicator of lower limb strength in the elderly and in people with disabling diseases. The aim of the work described in this thesis was to investigate and analyse the STS transition in two groups of healthy subjects, a cohort (n=10) of younger adult participants (age range 28±2 years) and a cohort (n=10) of older adult participants (age range 56±8 years), in order to identify the differences in the performances within and between the two groups when the STS transition was undertaken at different speeds. The two groups of participants performed STS transition trials at three, different, self-selected speeds (normal, slow and fast) during which data was recorded from a caption systems, consisting of a set of six infrared-cameras and two force plates. The in-vivo data obtained was applied to a link segment biomechanical model enabling the kinematic contribution of the major body segments to the STS activity to be determined for each participant. A principal component analysis (PCA) was undertaken to identify any aggregate and segmental differences in the STS transition performance between speeds. In addition, a kinetic analysis was performed to determine the torque and power contributions of the lower limb joints during the STS transition. The results from the analysis showed that younger and older participants performed the STS transition with a similar pattern, but they used different strategies to ascend according to the speed at which the activity was being performed. The younger participants used the same strategy at slow speed than the older participants used at slow and normal speeds. Likewise, the younger participants used the same strategy at normal and fast speeds as the older participants used at fast speed. From the segmental analysis it was found that the upper-body and pelvis segments presented the larger variability than the other segments. From the joint analysis, the knee and hip joints were identified as the joints that provide the greatest contribution to the STS transition as they generated most of the power and torque required for the activity. The results obtained and the methodology developed could help clinicians with the diagnosis, planning and selection of treatment for patients with a lack of mobility. This type of analysis may also find application in fields such as robotics, ergonomics and sports training.

The anconeus, a small triangular muscle positioned on the posterolateral part of the elbow joint, has been the subject of considerable research without a satisfactory conclusion being reached regarding the role it plays during normal elbow kinematics. The aim of this investigation was to elucidate the function of the anconeus muscle and find the relative contribution that it makes to elbow kinematics by examining relative electrical muscle activity and elbow kinematics both before and after anconeus defunctioning carried out using a local anaesthetic (lidocaine). The study was performed through an examination of the myoelectric activity of the representative elbow flexor and extensor muscles (biceps brachii and triceps brachii) and the elbow kinematics and kinetics. Right-handed, healthy volunteers performed elbow flexion-extension and supination-pronation movements in both horizontal and sagittal planes before and after blocking of the anconeus. The kinematics and kinetics of the elbow were assessed using inertial sensors, and muscle electrical activity was recorded using surface electromyography. In the following stage of the study, the anconeus muscle was blocked through an injection of lidocaine and then the flexion-extension and pronation-supination movements were repeated. The relative electrical activity results from the anconeus before blocking clearly indicate that the activity of the muscle was higher during the extension portion of the flexion-extension cycle, suggesting that it behaves as an extensor muscle. However, from the paired sample t-test analysis, it was found that blocking of the anconeus had no effect on the kinematics and kinetics of the elbow, including the angular velocity, net torque, power and net joint work. Moreover, the angular velocity data for the elbow, before and after the blocking for all movements, showed a linear trend with slopes and Pearson's correlations close to unity, indicating no apparent difference on the elbow kinematics. In addition, the relative electrical activity of the biceps and triceps brachii muscles did not alter significantly following blocking of the anconeus. These findings suggest that the anconeus muscle is a relatively weak elbow extensor as it is likely that the small contribution that the anconeus provides during extension before blocking is compensated by the triceps brachii after the anconeus is deactivated. In order to provide additional weight and support to the findings of the experimental study, a computational model of the elbow joint was created in Abaqus CAE with the aim of investigating the contribution of the anconeus during the flexion-extension motion. In particular, the effect on the range of motion and contact area of the elbow joint was investigated both before and after anconeus blocking. The analysis was done in a range of motion of 90°, starting with the elbow extended 30° and ending flexed 120°. The elbow joint model considered cortical bone, trabecular bone, cartilage, collateral ligaments, the anconeus, biceps brachii and triceps brachii. The results of the investigation indicated that the anconeus muscle does not produce a significant change in the range of motion and contact area in the articulation, an outcome that supports the findings of the experimental investigation.

Developmental dysplasia of the hip (DDH) refers to some hip disorders, from mildly dysplastic to hip joint dislocation. The main feature of DDH is the deficient acetabular coverage, which is related to a small contact area in the hip joint, and causes an increase in contact pressure. Ganz periacetabular osteotomy (PAO) is a surgical procedure to correct acetabular orientation in DDH. It changes the position of the acetabulum to increase the femoral head coverage and distribute the contact pressure over the cartilage surface. The procedure of Ganz PAO is technically demanding and its success depends significantly on the surgeon’s experience. The aim of this research is to investigate whether it is possible to optimize the position of the acetabular fragment in patients suffering DDH before a Ganz PAO by using finite element (FE) analysis. Using computed tomography (CT) data from patients with DDH, five three-dimensional (3D) hip models were developed. A virtual Ganz PAO was then performed on the hip models. FE analyses were carried out on the hip models before and after virtual Ganz PAO. Contact area, contact pressure and Von Mises stress in the hip cartilage were checked and analysed in order to find an optimal acetabular position. The first virtual surgery performed was only to rotate the acetabular fragment in the lateral direction to improve the acetabular coverage. Analyses were conducted under loading conditions associated with four commonly daily activities: one leg stance, normal walking, descending stairs and knee bend. Second virtual surgery performed was to rotate the fragment in both the lateral and anterior directions and FE analysis conducted for one leg stance loading condition. Contact area, contact pressure and Von Mises stress in the cartilage all varied according to the change of the acetabular fragment position through virtual Ganz PAO. The optimal lateral position of the acetabular fragment occurs close to the inferior border of its normal range. Large anterior position of the acetabular fragment results in large contact area, low contact pressure and Von Mises stress. However, an overcorrection of the acetabular fragment, especially in the anterior correction, leads to problems in performing normal hip movements. The optimal anterior position of the acetabular fragment is therefore close to the superior limit of the normal range. In conclusion, the present analysis shows that an optimal position of the acetabular fragment for patients suffering DDH which improves the acetabular femoral head coverage in the normal range, maximizes the contact area and minimizes the contact pressure and Von Mises stress can be established using 3D models and FE analysis. This information will be useful to the surgeons for the planning of PAO.

Lumbar intervertebral disc disorder is a spinal condition that affects the normal function of the intervertebral discs mainly due to the natural aging process. This condition can manifest itself in pain and limited motion in the legs, amongst others. Posterolateral Fusion (PLF) and Posterior Lumbar Interbody Fusion (PLIF) are two of the most used surgical procedures for treating lumbar intervertebral disc disease. Although these procedures are commonly used and performed successfully the impact in terms of the stresses developed in the posterior implants employed and in the spinal components adjacent to the surgical site has not been exhaustively investigated. In addition, the consequences of the procedure on the reduction of the Range of Motion of the lumbar spine is not clearly understood. The objective of this research is to investigate the effect of one-level spinal fusion of lumbar segment L4-L5 on the stresses and the range of motion at the remaining, adjacent lumbar levels. Four 3 dimensional finite element models of a lumbosacral spine were created from Computer Tomography data (CT scan). The models were used to investigate four surgical scenarios, including the use of 0o and 4o interbody cages, in addition to the un-instrumented spine for flexion, extension, torsion and lateral bending motions. The predictions obtained from the models enabled the mechanical behaviour of the lumbar spine following fusion surgery using 0 o and 4o cages to be investigated and compared. In addition, a clinical study was performed to quantify the reduction in the range of motion for subjects who had undergone L4/5 posterior lumbar interbody fusion surgery. The clinical results were compared to those of subjects who had not undergone surgery and to the range of motion predictions from the computational model. The results from this research demonstrate that the insertion of posterior instrumentation does not have an impact on the spinal structures above the L3/4 intervertebral disc. However, the pedicle screws and the insertion of the interbody cages causes stress levels in the area adjacent to the surgical site to rise which could promote accelerated degeneration of the discs. Additionally, this study demonstrates how the pedicle screws are affected by the surgical spinal fusion techniques. Furthermore, the investigation demonstrates how posterior lumbar interbody fusion causes the range of motion of patients that had undergone this surgery to decrease. The results from the comparison of the behaviour of the use of 0º and 4º interbody cages in L4-5 posterolateral fusion demonstrates that the stress levels in the adjacent vertebrae, intervertebral discs and pedicle screw fixation system increase when 4º are used cages than when 0º cages were employed. The results from the in-vitro study show a decrease in the range of motion of the subjects who had undergone L4/5 posterior lumbar interbody fusion surgery when compared with the subjects with no low back pain history. This indicates that the PLIF surgery combined with the normal disc degeneration is subjected to higher stresses than the healthy spine.

In the diagnosis and analysis of shoulder instability a precise determination of the location and orientation of the Glenohumeral joint is important. A better understanding of shoulder kinematics and kinetics will help clinicians and therapists in the diagnosis and treatment of shoulder pathologies. To-date, non-invasive skin-based methods are often either restricted to quasi-static measurements or are inaccurate during dynamic assessments at high humeral elevations as a result of soft skin artefact. Tracking the orientation of the scapula is difficult because it is surrounded by soft tissues, is held mainly by muscles and has only one direct point of attachment to the thorax. Instability of the glenohumeral joint generates poor functionality of the shoulder labrum and capsule as well as in the muscle and connective tissue structures that surround the shoulder. As the clinical phenomenon of shoulder instability is extremely complex, one of the priorities for the specialist in avoiding a faulty diagnosis is to recognise, identify and classify shoulder pathologies such as muscle patterning instability in the early stages of the investigation. A two stage methodology for non-invasive tracking of the scapula under dynamic conditions is presented in this work. The methodology provides scapula location by combining data from two surface mounted sensors using a regression-type equation formulated from quasi-static trials undertaken using a scapula locator and three IMUs (first stage). In the second stage, the least square fit is used to improve the scapular orientation by utilising data from only two IMUs (humerus and scapula) under dynamic conditions. Accuracy was assessed in an animal study by comparing results with those from a bone based method during quasi static and dynamic tests. Tests were also undertaken to investigate the errors induced by the soft tissue artefact in surface based scapula location measurement. In dynamic trials the methodology proved more accurate in determining scapula location than a standard skin-based approach, and showed that the greatest contribution to soft tissue artefact was from the epidermal, dermal and subcutaneous tissue layers as opposed to the muscle layer. We confirmed that, in cases where subjects have relatively small amounts of soft tissue surrounding the scapula, surface based methods could provide reasonable accuracy. Our methodology utilised subject-specific data to formulate a regression equation, and can be used to provide accurate, non-invasive tracking of the scapula under dynamic conditions in subjects regardless of individual body morphology. After the methodology validation, study tests were undertaken in a case study in order to estimate the scapula orientation under dynamic conditions in a human without symptoms of any shoulder pathologies and in one participant diagnosed with shoulder instability due to muscle patterning. The two stage methodology is proven to work in a healthy human participant in dynamic tests, in a person with no suspicion of shoulder instability. This methodology allows the error reduction generated by the soft tissues surrounded the scapula. The work presented here can be used as a framework for developing diagnosis protocols by using modern technology.

Bilateral breast augmentation is one of the most common cosmetic surgical procedures carried out on women in the western world. Breast augmentation involves increasing the volume of a woman‘s breasts through surgery by placing a silicone implant in the subglandular or subpectoral cavity. Although a capsule forms inevitably around breast implants as a natural part of healing, it can cause significant morbidity if the capsule becomes firm and contracted, a condition known as breast capsular contracture (BCC). The aetiology of BCC remains unknown however it is characterised by dense fibrocollagenous connective tissue with a local inflammatory response. Host response is influenced by several factors including implant surface texture, chemistry and interactions between cells and the extracellular matrix. Texturing holds the implant in place, thus preventing micromotion at the host prosthesis interface. While in smooth surfaces, the implant moves inside the breast, making the fibroblasts repeatedly produce collagen in response to this host-prosthesis shearing motion. In this thesis, the effect of surface characteristics and specific coatings on the cell-surface interaction has been examined on smooth compared to textured surfaces using commercially available breast implants. The properties of breast implants shells have been characterised using confocal laser microscopy, contact angle measurements, confocal Raman spectroscopy and tensile testing. Confocal laser microscopy was used to evaluate the topographical features and surface roughness of the implant surfaces. Contact angle measurements were carried out to determine the hydrophobicity of the implant surfaces. Chemical characterisation was carried out recording Raman images and spectra of the implants using confocal Raman spectrometer. The mechanical properties of the breast implant shells were measured via tensile testing. Adhesive interactions of breast-derived fibroblasts with breast implant surfaces were examined in-vitro. For this purpose, the effect of four molecule coatings (aggrecan, collagen I, fibronectin, and hyaluronic acid) was evaluated on fibroblast attachment, proliferation, fibroblast morphology, spreading, cytotoxicity and gene expression. Results from in-vitro assays demonstrated cell susceptibility to topography and protein coatings and further showed cytoskeletal re-organisation and modification with specific cell adhesion patterns. Combination of diverse topographies and specific coatings induced differential regulation of the expression of adhesion related genes, such as focal adhesion kinase, paxillin, vinculin, and α-actinin on breast fibroblasts. In conclusion, this thesis has demonstrated the extent and strength of cell adhesion and subsequent cell proliferation and differentiation. This is based on the physical interactions between cells and the extracellular environment in the form of topography and on the chemical interactions mediated by specific coatings. Precise characterisation of the silicone breast implant surfaces was achieved. This may play an important role in the development of improved breast implant surfaces with improved qualities leading the development of surfaces that may be less prone to capsular contracture.

Immobilisation has been one of the common forms of treatments for orthopaedic injuries and diseases. Immobilisation of injured limbs using dynamic splinting is routinely recommended by clinicians for fast healing as it promotes blood flow and provides the require stability. There are several dynamic splints available in the market that make use of different materials and mechanical elements. This research was set out to investigate the applicability of Magneto-Rheological(MR) fluids for the development of a smart fabric for orthopaedic splints. The fabric would be woven with hollow fibres containing MR fluid, which will change stiffness in an applied magnetic field. The concept was tested by measuring changes in the stiffness of silicone tubings in two different diameters filled with MR fluid, under different magnetic flux densities. The corresponding changes in stiffness of a preliminary fabric specimen built with woven tubings and cast liner was also investigated. The magnetic field was created after a set of detailed experimental and numerical analyses (Finite Element Method). It was found that although the electromagnets are much more versatile and easier to control for a required magnitude of magnetic flux density, they were found to be unsatisfactory due to their weight, bulk, and substantial requirement of batterie power. Permanent magnets offered a much better solution. After detailed preliminary analyses, an array of 21 neodymium magnets was chose for the experiments, which provided the required magnitude and uniformity of the magnetic field. The specimens were loaded in steps by small weights, and the resulting deflection was measured using an optical deformation analysis system. The equivalent Young’s modulus was found to increase from 16 MPa to 122 MPa under an average magnetic flux density of 0.0139 Tesla, which is an in- crease of 70%. A finite-element (FE) model of the single tubing test set up was developed and validated against the experimental results. The FE analysis was extended to the fabric specimens. The difference between the experimental and numerical results for the single tubing was as small as 2.5%, and 9.2% for the fabric. Furthermore, a preliminary numerical model and analysis of the hand was developed, which set the basis in the development of a further numerical analysis in the final development of the fabric. Upon the completion of the tests and simulation, it was concluded that a woven fabric made up of hollow fibres containing MR fluid can be an effective dynamic splint over a small area such as the wrist. However a fully functional product would require further research.