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The analysis of intra-cycle velocity profile of manual wheelchair (MWC) users has been used to highlight the significant role of trunk inertia in propulsion biomechanics. Maximal wheelchair linear velocity has previously been observed to be reached after the release of the handrims both during sports activities and daily life propulsion. This paper provides a combined analysis of linear velocity and trunk kinematics in elite wheelchair racing athletes during straight-line propulsion at stabilized speeds. MWC and trunk kinematics of eight athletes (level: 7 elite, 1 intermediate; classification: T54 (5), T53 (2) and T52 (1)) were monitored during 400 m races using inertial measurement units. An average propulsion cycle was computed for each athlete. The main finding of this article is the difference in propulsion patterns among the athletes, exhibiting either 1, 2 or 3 peaks in their velocity profile. A second peak in velocity is usually assumed to be caused by the inertia of the trunk. However, the presence of a second velocity peak among more severely impaired athletes with little to no trunk motion can either be associated to the inertia of the athletes’ arms or to their propulsion technique.

Back pain is prevalent among gymnast populations and extreme flexion or extension of the lumbar spine along with high ground reaction forces (GRFs) are known to increase intervertebral stress. The aim of this study was to determine which postures and dynamic conditions among common floor movements provide the greatest risk of injury in men’s artistic gymnastics (MAG). For this purpose, lumbar spine curvatures, obtained through a full-body subject-specific kinematic model fed by motion capture data, and GRFs on feet and hands were compared between typical floor movements of MAG (pike jump, round off back handspring, front handspring, forward and backward tucked somersaults) performed by six adolescent gymnasts. The round off back handspring and the pike jump resulted respectively in the largest lumbar extension and flexion, and the forward tucked somersault take-off in the highest GRF. At ground impacts, the largest lumbar flexion was during the backward tucked somersault landing and only the back handspring hands ground contact phase led to lumbar extension. Such identification of high-risk conditions should enable better back pain management in gymnastics through more tailored training adaptations, particularly in case of pathologies or musculoskeletal specificities. French Gymnastics Federation French ministry of sports (Grant 19r33)

Background: Vertical whole-body vibration (vWBV) during work, recreation, and transportation can have detrimental effects on physical and mental health. Studies have shown that lateral vibration at low frequencies ( 3 Hz). This study seeks to assess the effect of vWBV on spatiotemporal gait parameters at a greater range of frequencies (≤ 30 Hz). Methods: Stride Frequency (SF), Stride Length (SL), and Center of Pressure velocity (CoPv) was measured in seven male subjects (23 ± 4 years, 1.79 ± 0.05 m, 73.9 ± 9.7 kg) during In-Place Walking and nine male subjects (29 ± 7 years, 1.78 ± 0.07 m, 77.8 ± 9.9 kg; mean ± SD) during Treadmill Walking while exposed to vWBV. Load cells measured ground reaction forces during In-Place Walking and sensorized insoles acquired under-foot pressure during Treadmill Walking. Statistical tests included a one-way repeated-measures ANOVA, post-hoc two way paired T-tests, statistical power (1-β), correlation (R 2 ), and effect size (Cohen’s d). Results: While statistical significance was not found for changes in SF, SL, or Mean CoPv, small to large effects were found in all measured spatiotemporal parameters of both setups. During Treadmill Walking, vWBV was correlated with a decrease in SF (R 2 = 0.925), an increase in SL (R 2 = 0.908), and an increase in Mean CoPv (R 2 = 0.921) and Max CoPv (R 2 = 0.952) with a significant increase (p < 0.0083) in Max CoPv at frequencies of 8 Hz and higher. Significance: Study results demonstrated that vWBV influences spatiotemporal gait parameters at frequencies greater than previously studied. Istituto Nazionale per l’As­sicurazione contro gli Infortuni sul Lavoro (INAIL)

Pressure ulcers are a severe disease affecting patients that are bedridden or in a wheelchair bound for long periods of time. These wounds can develop in the deep layers of the skin of specific parts of the body, mostly on heels or sacrum, making them hard to detect in their early stages. Strain levels have been identified as a direct danger indicator for triggering pressure ulcers. Prevention could be possible with the implementation of subject-specific Finite Element (FE) models. However, generation and validation of such FE models is a complex task, and the current implemented techniques offer only a partial solution of the entire problem considering only external displacements and pressures, or cadaveric samples. In this paper, we propose an in vivo solution based on the 3D non-rigid registration between two Magnetic Resonance (MR) images, one in an unloaded configuration and the other deformed by means of a plate or an indenter. From the results of the image registration, the displacement field and subsequent strain maps for the soft tissues were computed. An extensive study, considering different cases (on heel pad and sacrum regions) was performed to evaluate the reproducibility and accuracy of the results obtained with this methodology. The implemented technique can give insight for several applications. It adds a useful tool for better understanding the propagation of deformations in the heel soft tissues that could generate pressure ulcers. This methodology can be used to obtain data on the material properties of the soft tissues to define constitutive laws for FE simulations and finally it offers a promising technique for validating FE models. This research has received funding from the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie Grant Agreement No. 811965; project STINTS (Skin Tissue Integrity under Shear). IRMaGe MRI facility was partly funded by the French program "Investissement d'Avenir" run by the "Agence Nationale pour la Recherche”; grant "Infrastructure d'avenir en Biologie Sante" - ANR-11-INSB-0006.

Two third of manual wheelchair (MWC) users report suffering or having suffered from shoulder pain or injury [1]. To favour the understanding of these disorders, it is crucial to quantify the shoulder kinematics and kinetics during MWC locomotion [2]. However, soft tissue artefacts (STA) are particularly present at the scapula, making it difficult to accurately track the bone motion [3], motivating researchers to propose compensation methods based on acromion or scapula spine marker clusters and a calibration pose [4]. Apart from invasive or irradiative methods, the reference method to localize the scapula bone is based on external palpation generally through the use of a scapula palpator (SP) [5]. In this study, we propose to compare the scapula kinematics reconstructed from a cluster with STA compensation based on one or two calibration static poses during the push phase with the reference method using a SP. ANR-19-CE19-0007

The increasing use of 3-dimensional (3D) imaging by orthodontists and maxillofacial surgeons to assess complex dentofacial deformities and plan orthognathic surgeries implies a critical need for 3D cephalometric analysis. Although promising methods were suggested to localize 3D landmarks automatically, concerns about robustness and generalizability restrain their clinical use. Consequently, highly trained operators remain needed to perform manual landmarking. In this retrospective diagnostic study, we aimed to train and evaluate a deep learning (DL) pipeline based on SpatialConfiguration-Net for automatic localization of 3D cephalometric landmarks on computed tomography (CT) scans. A retrospective sample of consecutive presurgical CT scans was randomly distributed between a training/validation set ( n = 160) and a test set ( n = 38). The reference data consisted of 33 landmarks, manually localized once by 1 operator( n = 178) or twice by 3 operators ( n = 20, test set only). After inference on the test set, 1 CT scan showed “very low” confidence level predictions; we excluded it from the overall analysis but still assessed and discussed the corresponding results. The model performance was evaluated by comparing the predictions with the reference data; the outcome set included localization accuracy, cephalometric measurements, and comparison to manual landmarking reproducibility. On the hold-out test set, the mean localization error was 1.0 ± 1.3 mm, while success detection rates for 2.0, 2.5, and 3.0 mm were 90.4%, 93.6%, and 95.4%, respectively. Mean errors were −0.3 ± 1.3° and −0.1 ± 0.7 mm for angular and linear measurements, respectively. When compared to manual reproducibility, the measurements were within the Bland–Altman 95% limits of agreement for 91.9% and 71.8% of skeletal and dentoalveolar variables, respectively. To conclude, while our DL method still requires improvement, it provided highly accurate 3D landmark localization on a challenging test set, with a reliability for skeletal evaluation on par with what clinicians obtain.

During manual wheelchair (MWC) locomotion, the user's upper limbs are subject to heavy stresses and fatigue because the upper body is permanently engaged to propel the MWC. These stresses and fatigue vary according to the environmental barriers encountered outdoors along a given path. This study aimed at conducting a systematic review of the literature assessing the biomechanics of MWC users crossing various situations, which represent physical environmental barriers. Through a systematic search on PubMed, 34 articles were selected and classified according to the investigated environmental barriers: slope; cross-slope; curb; and ground type. For each barrier, biomechanical parameters were divided into four categories: spatiotemporal parameters; kinematics; kinetics; and muscle activity. All results from the different studies were gathered, including numerical data, and assessed with respect to the methodology used in each study. This review sheds light on the fact that certain situations (cross-slopes and curbs) or parameters (kinematics) have scarcely been studied, and that a wider set of situations should be studied. Five recommendations were made at the end of this review process to standardize the procedure when reporting materials, methods, and results for the study of biomechanics of any environmental barrier encountered in MWC locomotion: (i) effectively reporting barriers’ lengths, grades, or heights; (ii) striving for standardization or a report of the approach conditions of the barrier, such as velocity, especially on curbs; (iii) reporting the configuration of the used MWC, and if it was fitted to the subject’s morphology; (iv) reporting rotation sequences for the expression of moments and kinematics, and when used, the definition of the musculoskeletal model; lastly (v) when possible, reporting measurement uncertainties and model reconstruction errors. This study was funded by the French National Research Agency, “Agence Nationale de la Recherche” (https://anr.fr/) by a grant awarded to the following authors: T.R., A.L., J.B., C.P., H.P., C.S. Grant number: ANR-19-CE19-0007

BackgroundFor both sports and everyday use, finding the optimal manual wheelchair (MWC) configuration can improve a user's propulsion biomechanics. Many studies have already investigated the effect of changes in MWC configuration but comparing their results is challenging due to the differences in experimental methodologies between articles.PurposeThe present systematic review aims at offering an in-depth analysis of the methodologies used to study the impact of MWC configuration on propulsion biomechanics, and ultimately providing the community with recommendations for future research.MethodsThe reviewing process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart on two databases (Scopus and PubMed) in March 2022.ResultsForty-five articles were included, and the results highlighted the multiplicity of methodologies regarding different experimental aspects, including propulsion environment, experimental task, or measurement systems, for example. More importantly, descriptions of MWC configurations and their modifications differed significantly between studies and led to a lack of critical information in many cases.DiscussionStudying the effect of MWC configuration on propulsion requires recommendations that must be clarified: (1) the formalism chosen to describe MWC configuration (absolute or relative) should be consistent with the type of study conducted and should be documented enough to allow for switching to the other formalism; (2) the tested MWC characteristics and initial configuration, allowing the reproduction or comparison in future studies, should be properly reported; (3) the bias induced by the experimental situation on the measured data must be considered when drawing conclusions and therefore experimental conditions such as propulsion speed or the effect of the instrumentation should be reported.ConclusionOverall, future studies will need standardization to be able to follow the listed recommendations, both to describe MWC configuration and mechanical properties in a clear way and to choose the experimental conditions best suited to their objectives.

Summary Objectives Table tennis is a widely practiced sport, often described as a reaction sport. Therefore, players need to practice extensively that may expose them to overuse injuries. For optimizing training with limitation of the injury risk, the knowledges of table tennis physiology, biomechanics and epidemiology are of primary interest. Methods For that purpose, a literature review has been made through a systematic search on three scientific databases. Overall, table tennis physiology is complex due to intense and intermittent efforts. It results that some technological challenges still need to be addressed to accurately quantify this physiology. Besides, current rules changes may modify the table tennis physiological requirements. Results Findings in neurophysiology tend to define table tennis as an anticipation sport rather than a reaction sport and higher occulo-motor skills were found in table tennis population with respect to average population. Regarding biomechanics, some rare studies have been done but none had investigated the energy flow between the upper- and the lower-body, which would be interesting to understand how the energy generated by the footwork contributes to racket velocity. Conclusion Finally, epidemiological studies lack of details on injury locations and diagnosis. These data could be of high interest to improve medical and training care.

International audience; Subject-specific tensioning of ligaments is essential for the stability of the knee joint and represents a challenging aspect in the development of finite element models. We aimed to introduce and evaluate a new procedure for the quantification of ligament prestrains from biplanar X-ray and CT data. Subject-specific model evaluation was performed by comparing predicted femorotibial kinematics with the in vitro response of six cadaveric specimens. The differences obtained using personalized models were comparable to those reported in similar studies in the literature. This study is the first step toward the use of simplified, personalized knee FE models in clinical context such as ligament balancing.

An alternative method for solving constrained Multibody kinematics optimisation using a penalty method on constraints and a Levenberg-Marquardt algorithm is proposed. It is compared to an optimisation resolution with hard kinematic constraints. These methods are applied to two pairs of experiments and models. The penalty method was at least 20 times faster than the optimisation resolution while keeping similar reconstruction errors and constraints violation. The potential of the method is shown to accurately solve the Multibody kinematics optimisation problem in a reasonable amount of time. A computational gain lies in implementing this resolution with a compiled and optimised program code. This study was conducted as part of the CapaCITIES project, funded by the French National Research Agency (ANR-19-CE19-0007).

Purpose: To assess dynamic postural alignment in ASD during walking using a subject-specific 3D approach. Methods: 69 ASD (51 ± 20 years, 77%F) and 62 controls (34 ± 13 years, 62%F) underwent gait analysis along with full-body biplanar Xrays and filled HRQoL questionnaires. Spinopelvic and postural parameters were computed from 3D skeletal reconstructions, including radiographic odontoid to hip axis angle (ODHA) that evaluates the head's position over the pelvis (rODHA), in addition to rSVA and rPT. The 3D bones were then registered on each gait frame to compute the dynamic ODHA (dODHA), dSVA, and dPT. Patients with high dODHA (> mean + 1SD in controls) were classified as ASD-DU (dynamically unbalanced), otherwise as ASD-DB (dynamically balanced). Between-group comparisons and relationship between parameters were investigated. Results: 26 patients were classified as ASD-DU having an average dODHA of 10.4° (ASD-DB: 1.2°, controls: 1.7°), dSVA of 112 mm (ASD-DB: 57 mm, controls: 43 mm), and dPT of 21° (ASD-DB: 18°, controls: 14°; all p < 0.001). On static radiographs, ASD-DU group showed more severe sagittal malalignment than ASD-DB, with more altered HRQoL outcomes. The ASD-DU group had an overall abnormal walking compared to ASD-DB & controls (gait deviation index: 81 versus 93 & 97 resp., p < 0.001) showing a reduced flexion/extension range of motion at the hips and knees with a slower gait speed and shorter step length. Dynamic ODHA was correlated to HRQoL scores. Conclusion: Dynamically unbalanced ASD had postural malalignment that persist during walking, associated with kinematic alterations in the trunk, pelvis, and lower limbs, making them more prone to falls. Dynamic-ODHA correlates better with HRQoL outcomes than dSVA and dPT.

Soumission associée au prix jeune chercheur 2021 de la Société de Biomécanique Background Pressure-induced tissue strain is one major pathway for Pressure Ulcer development and, especially, Deep Tissue Injury. Biomechanical investigation of the time-dependent stress–strain mechanical behaviour of skeletal muscle tissue is therefore essential. In the literature, a viscoelastic formulation is generally assumed for the experimental characterization of skeletal muscles, with the limitation that the underlying physical mechanisms that give rise to the time dependent stress–strain behaviour are not known. The objective of this study is to explore the capability of poroelasticity to reproduce the apparent viscoelastic behaviour of passive muscle tissue under confined compression. Methods Experimental stress-relaxation response of 31 cylindrical porcine samples tested under fast and slow confined compression by Vaidya and collaborators were used. An axisymmetric Finite Element model was developed in ABAQUS and, for each sample a one-to-one inverse analysis was performed to calibrate the specimen-specific constitutive parameters, namely, the drained Young's modulus, the void ratio, hydraulic permeability, the Poisson's ratio, the solid grain's and fluid's bulk moduli. Findings The peak stress and consolidation were recovered for most of the samples (N = 25) by the poroelastic model (normalised root-mean-square error ≤0.03 for fast and slow confined compression conditions). Interpretation The strength of the proposed model is its fewer number of variables (N = 6 for the proposed poroelastic model versus N = 18 for the viscohyperelastic model proposed by Vaidya and collaborators). The incorporation of poroelasticity to clinical models of Pessure Ulcer formation could lead to more precise and mechanistic explorations of soft tissue injury risk factors.

The success of biomedical implantation is linked to osseointegration, depending on the mechanical loading of the bone interface. The large difference in stiffness between the host bone (30 GPa) and the usual implant material (over 100 GPa), as well as the absence of mechanical stress at the surrounding bone, induce a stress shielding effect, which leads to bone atrophy and implant loss. A recent work has shown the possibility to produce so-called second-generation titanium alloys. β-type Ti alloys have been studied for biomedical applications, due to the composition of non-cytotoxic elements. Some TiNb alloys can reach after heat treatment a Young’s modulus close to 35 GPa, which is really close to bone’s one. Unfortunately, titanium and its alloys are well known for their poor machinability due to the hardness and low thermal conductivity. Machined surfaces of titanium alloys are also easily damaged (micro cracks, build-up edge, plastic deformation, heat-affected zones, and tension residual stresses) during the process. Studying process parameters is important to avoid these phenomena. The machinability of TiNb (turning, milling) has not been studied to date. Therefore, in this study, we examined the behavior of the TiNb titanium alloy for applications as a biomaterial in micro-cutting. Orthogonal cutting tests were performed on austenite and martensite states TiNb alloys and compared with Ti40 pure titanium. The aim was to evaluate the influence of the alloys and the cutting parameters on the evolution of the cutting forces, specific cutting energy, friction coefficient which are good indicators of machinability.

Introduction X-linked hypophosphatemia (XLH) rickets mainly causes leg deformities in children that can get worse as they grow. We hypothesized that quantifying the bone parameters will help to document and monitor these deformities in children with XLH. Methods Thirty-five growing children affected by XLH were included in this cross-sectional study. Biplanar radiographs were taken with an EOS system allowing 3D reconstructions of the pelvis and legs. Sixteen geometric parameters were calculated for the legs and pelvis. A control group of 40 age-matched patients was used to define the reference values for these geometric parameters. Results For the legs, significant differences (p < 0.05) appeared between the XLH patients and the control group in the neck-shaft angle, femur/tibia length ratio and HKS. Among the 70 legs in the XLH group, 23 were in genu varum, 25 were in genu valgum and 22 were straight. There were significant differences between the genu varum and genu valgum subgroups in the femoral mechanical angle and the HKS. A strong correlation was found between the femoral mechanical angle and tibiofemoral angle (r² = 0.73) and between the femoral mechanical angle and HKS (r²=0.69) The sacral slope and acetabular anteversion were significant different from the reference values. Discussion Quantitative radiological parameters derived from 3D reconstructions show that the deformities in XLH patients are 1) mainly in but not limited to the femoral shaft; 2) highly variable from one person to another. Some of these radiological parameters may be useful for the diagnosis and monitoring of XLH patients. Kyowa Kirin Pharma provided financial support for this study.

Amplified by the development of new technologies, the interest in personal performance has been growing over the last years. Acceleration has proved to be an easy variable to collect, and was addressed in several works. However, few of them evaluate the effect of running speed on relevant indicators. The influence of the sensors location on the measurement is rarely studied as well. This study is dedicated to investigating the effect of running speed on acceleration measured at three different positions on 18 volunteers. All participants were equipped with three inertial measurement units: on the dorsal surface of the right foot (Fo), at the centre of gravity of the tibia (Ti), at the L4-L5 lumbar (Lu). The test was performed on a treadmill at nine randomised speeds between 8 and 18 km/h. Ten accelerometric variables were calculated. Linear regressions were used to calculate speed from the indicators calculated on (Lu), (Ti), (Fo). Indicators associated to signal energy were highly correlated with speed ( r 2 > 0.90 ). Median frequency appears to be affected by the frequency resolution. Finally, the measurement points closest to the impact zone result in the most correlated indicators.

Impingement with surrounding tissues is a major cause of failure of anterior cruciate ligament reconstruction. However, the complexity of the knee kinematics and anatomical variations make it difficult to predict the occurrence of contact and the extent of the resulting damage. Here we hypothesise that a description of wear between the reconstructed ligament and adjacent structures captures the in vivo damage produced with physiological loadings. To test this, we performed an in vivo study on a sheep model and investigated the role of different sources of damage: overstretching, excessive twist, excessive compression, and wear. Seven sheep underwent cranial cruciate ligament reconstruction using a tendon autograft. Necropsy observations and pull-out force measurements performed postoperatively at three months showed high variability across specimens of the extent and location of graft damage. Using 3D digital models of each stifle based on X-ray imaging and kinematics measurements, we determined the relative displacements between the graft and the surrounding bones and computed a wear index describing the work of friction forces underwent by the graft during a full flexion-extension movement. While tensile strain, angle of twist and impingement volume showed no correlation with pull-out force (ρ = −0.321, p = 0.498), the wear index showed a strong negative correlation (r = −0.902, p = 0.006). Moreover, contour maps showing the distribution of wear on the graft were consistent with the observations of damage during the necropsy. These results demonstrate that wear is a good proxy of graft damage. The proposed wear index could be used in implant design and surgery planning to minimise the risk of implant failure. Its application to sheep can provide a way to increase preclinical testing efficiency.

Background: Physiologic aging is associated with loss of mobility, sarcopenia, skin atrophy and loss of elasticity. These factors contribute, in the elderly, to the occurrence of a pressure ulcer (PU). Brightness mode ultrasound (US) and shear wave elastography (SWE) have been proposed as a patient-specific, bedside, and predictive tool for PU. However, reliability and clinical feasibility in application to the sacral region have not been clearly established. Method: The current study aimed to propose a simple bedside protocol combining US and SWE. The protocol was first tested on a group of 19 healthy young subjects by two operators. The measurements were repeated three times. Eight parameters were evaluated at the medial sacral crest. Intraclass Correlation Coefficient (ICC) was used for reliability assessment and the modified Bland Altman plot analysis for agreement assessment. The protocol was then evaluated for clinical feasibility on a healthy older group of 11 subjects with a mean age of 65 ± 2.4 yrs. Findings: ICC showed poor to good reliability except for skin SWE and hypodermis thickness with an ICC (reported as: mean(95%CI)) of 0.78(0.50-0.91) and 0.98(0.95-0.99) respectively. No significant differences were observed between the young and older group except for the muscle Shear Wave Speed (SWS) (respectively 2.11 ± 0.27 m/s vs 1.70 ± 0.17 m/s). Interpretation: This is the first protocol combining US and SWE that can be proposed on a large scale in nursing homes. Reliability, however, was unsatisfactory for most parameters despite efforts to standardize the protocol and measurement definitions. Further studies are needed to improve reliability. This project has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No. 811965.

Background As a leading cause of disability with a high societal and economic cost, it is crucial to better understand risk factors of neck pain and surgical complications. Getting subject-specific external loading is essential for quantifying muscle forces and joint loads but it requires exertion trials and load cells which are uncommon in clinical settings. Methods This paper presents a method to compute the gravitational loading at four levels of the cervical spine (C3C4, C4C5, C5C6, C6C7) in neutral standing position from biplanar radiographs exclusively. The resulting load was decomposed in local disc frames and its components were used to compare different populations: 118 asymptomatic subjects and 46 patients before and after surgery (anterior cervical discectomy and fusion or total disc replacement). Comparisons were performed at C6C7 and the upper level adjacent to surgery. Findings Significant changes in gravitational loading were observed with age in healthy subjects as well as in patients after surgery and have been associated with changes in posture. Interpretation This approach quantifies the influence of postural changes on gravitational loading on the cervical spine. It represents a simple way to obtain necessary input for muscle force quantification models in clinical routine and to use them for patient evaluation. The study of the subsequent subject-specific spinal loading could help further the understanding of cervical spine biomechanics, degeneration mechanisms and complications following surgery. Chaire BiomecAM de la Fondation ParisTech

EOS biplane radiographs of 117 subjects between 20 and 83 years were analyzed to compute the upper body lever arm over the L1 vertebra and its impact on vertebral strength. Postural sagittal alignment alteration was observed with age and resulted in a greater lever arm causing vertebral strength to decrease. The purpose of this study was to analyze the impact of postural alignment changes with age on vertebral strength using finite element analysis and barycentremetry. A total of 117 subjects from 20 to 83 years were divided in three age groups: young (20 to 40 years, 62 subjects), intermediate (40 to 60 years, 26 subjects), and elderly (60 years and over, 29 subjects). EOS biplane radiographs were acquired, allowing 3D reconstruction of the spine and body envelope as well as spinal, pelvic, and sagittal alignment parameter measurements. A barycentremetry method allowed the estimation of the mass and center of mass (CoM) position of the upper body above L1, relatively to the center of the L1 vertebra (lever arm). To investigate the effect of this lever arm, vertebral strength of a generic finite element model (with constant geometry and mechanical properties for all subjects) was successively computed applying the personalized lever arm of each subject. A combination of an increase in thoracic kyphosis, cervical lordosis, and pelvic tilt with a loss of lumbar lordosis was observed between the young and the older groups. Sagittal alignment parameters indicated a more forward position as age increased. The lever arm of the CoM above L1 varied from an average of 1 mm backward for the young group, to averages of 10 and 24 mm forward, respectively, for the intermediate and elderly group. As a result, vertebral strength decreased from 2527 N for the young group to 1820 N for the elderly group. The global sagittal alignment modifications observed with age were consistent with the literature. Posture alteration with age reduced vertebral strength significantly in this simplified loading model. Postural alignment seems essential to be considered in the evaluation of osteoporotic patients.

International audience; The osteoarticular architecture of the forearm can be modeled by an open or a closed-loop. This study aims to compare the impact of the chosen architecture on the muscle activity for overhead throwing motions. Preliminary results show similar muscle behaviors with both models.

Spheroids encapsulated within alginate capsules are emerging as suitable in vitro tools to investigate the impact of mechanical forces on tumor growth since the internal tumor pressure can be retrieved from the deformation of the capsule. Here we focus on the particular case of Cellular Capsule Technology (CCT). We show in this contribution that a modeling approach accounting for the triphasic nature of the spheroid (extracellular matrix, tumor cells and interstitial fluid) offers a new perspective of analysis revealing that the pressure retrieved experimentally cannot be interpreted as a direct picture of the pressure sustained by the tumor cells and, as such, cannot therefore be used to quantify the critical pressure which induces stress-induced phenotype switch in tumor cells. The proposed multiphase reactive poro-mechanical model was cross-validated. Parameter sensitivity analyses on the digital twin revealed that the main parameters determining the encapsulated growth configuration are different from those driving growth in free condition, confirming that radically different phenomena are at play. Results reported in this contribution support the idea that multiphase reactive poro-mechanics is an exceptional theoretical framework to attain an in-depth understanding of CCT experiments, to confirm their hypotheses and to further improve their design.

International audience; Manual wheelchair (MWC) propulsion can expose the user to significant vibration. Human body exposure to certain vibrations can be detrimental to health, and a source of discomfort and fatigue. Therefore, identifying vibration exposure and key parameters influencing vibration transmissibility during MWC propulsion is crucial to protect MWC users from vibration risks. For that purpose, a systematic review using PRISMA recommendations was realized to synthesize the current knowledge regarding vibration transmissibility during MWC propulsion. The 35 retrieved articles were classified into three groups: Vibration content, parameters influencing vibration transmission, and vibration transmission modeling. The review highlighted that MWC users experience vibration in the frequency range detrimental/uncomfortable for human vibration transmission during MWCpropulsion depends on many parameters and is still scarcely studied and understood. A modeling and simulation approach would be an interesting way to assist physicians in selecting the best settings for a specific user, but many works (modeling, properties identification, etc.) must be done before being effective for clinical and industrial purposes.

International audience; Objective: This paper reports on the quantification of passive wrist joint stiffness and investigates the potential influence of handedness and gender on stiffness estimates.Methods: We evaluated the torque-angle relationship during passive wrist movements in 2 degrees of freedom (into flexion-extension and radial-ulnar deviation) in 13 healthy subjects using a wrist robot. Experimental results determined intrasubject differences between dominant and nondominant wrist and intersubject differences between male and female participants.Results: We found differences in the magnitude of passive stiffness of left- and right-hand dominant males and right-hand dominant females suggesting that the dominant hand tends to be stiffer than the nondominant hand. Left-hand stiffness magnitude was found to be 37% higher than the right-hand stiffness magnitude in the left-handed male group and the right-hand stiffness magnitude was 11% and 40% higher in the right-handed male and female groups, respectively. Other joint stiffness features such as the orientation and the anisotropy of wrist stiffness followed the expected pattern from previous studies.Conclusion: The observed difference in wrist stiffness between the dominant and nondominant limb is likely due to biomechanical adaptations to repetitive asymmetric activities (such as squash, tennis, basketball, or activities of daily living such as writing, teeth brushing, etc.). Significance: Understanding and quantifying handedness influence on stiffness may have critical implication for the optimization of surgical and rehabilitative interventions.

The role of the above-knee socket is to ensure the load transfer via the coupling of residual limb-prosthesis with minimal discomfort and without damaging the soft tissues. Modelling is a potential tool to predict socket fit prior to manufacture. However, state-of-the-art models only include the femur in soft tissues submitted to static loads neglecting the contribution of the hip joint. The hip joint is particularly challenging to model because it requires to compute the forces of muscles inserting on the residual limb. This work proposes a modelling of the hip joint including the estimation of muscular forces using a combined MusculoSKeletal (MSK)/Finite Element (FE) framework. An experimental-numerical approach was conducted on one femoral amputee subject. This allowed to i) model the hip joint and personalise muscular forces, ii) study the impact of the ischial support, and iii) evaluate the interface pressure. A reduction of the gluteus medius force from the MSK modelling was noticed when considering the ischial support. Interface pressure, predicted between 63 to 71 kPa, agreed with experimental literature data. The contribution of the hip joint is a key element of the modelling approach for the prediction of the socket interface pressure with the residual limb soft tissues.

The analysis of the body center of mass (BCoM) 3D kinematics provides insights on crucial aspects of locomotion, especially in populations with gait impairment such as people with amputation. In this paper, a wearable framework based on the use of different magneto-inertial measurement unit (MIMU) networks is proposed to obtain both BCoM acceleration and velocity. The proposed framework was validated as a proof of concept in one transfemoral amputee against data from force plates (acceleration) and an optoelectronic system (acceleration and velocity). The impact in terms of estimation accuracy when using a sensor network rather than a single MIMU at trunk level was also investigated. The estimated velocity and acceleration reached a strong agreement (ρ &gt, 0.89) and good accuracy compared to reference data (normalized root mean square error (NRMSE) &lt, 13.7%) in the anteroposterior and vertical directions when using three MIMUs on the trunk and both shanks and in all three directions when adding MIMUs on both thighs (ρ &gt, 0.89, NRMSE ≤ 14.0% in the mediolateral direction). Conversely, only the vertical component of the BCoM kinematics was accurately captured when considering a single MIMU. These results suggest that inertial sensor networks may represent a valid alternative to laboratory-based instruments for 3D BCoM kinematics quantification in lower-limb amputees.

International audience; In case of transtibial amputation, the deficit resulting from the loss of the lower limb can be partly compensated with a prosthetic foot and adapted rehabilitation. New prosthetic feet have been developed for transtibial amputees to mimic ankle adaptability to varying terrain. Among them, Microprocessor Prosthetic Ankles (MPA) have a microprocessor to control an electric or a hydraulic actuator to adapt ankle kinematics in stairs and slopes. The objective is to investigate parameters extracted from the moment-angle curve (MAC) and use them to compare 3 MPA during level and slope locomotion against energy storing and return (ESR) foot. Five persons with lower limb transtibial amputation successively fitted with 3 MPA (Propriofoot™, Elan™, Meridium™) compared to their ESR foot. The participants had 2 weeks of adaptation before data acquisition and then a 3 week wash-out period. Range of motion, equilibrium point, hysteresis, late stance energy released, and quasi-stiffness were computed on level ground and 12% slope (upward and downward) thanks to the MAC at the ankle. The study shows the relevance of MAC parameters to evaluate the behavior of MPA. In particular, compared to ESR, all MPA tested in the present study demonstrated a better angle adaptation between walking conditions but a decrease of available energy for the propulsion. Among MPA, main results were: (i) for the Propriofoot™: an adaptation of the ankle angle without modification of the pattern of the MAC (ii) for the Elan™: a limited adaptation of the range of motion but a modification of the energy released (iii) for the Meridium™, the highest adaptation of the range of motion but the lowest available energy of propulsion. One of the main findings of the research is to show and quantify the relationship between range of motion and energy available when using different prosthetic feet in different walking conditions.

Modelling the foot-ankle system (FAS) while exposed to foot-transmitted vibration (FTV) is essential for designing inhibition methods to prevent the effects of vibration-induced white-foot. K-means analysis was conducted on a data set containing vibration transmissibility from the floor to 24 anatomical locations on the right foot of 21 participants. The K-means analysis found three locations to be sufficient for summarising the FTV response. A three segment, four degrees-of-freedom lumped parameter model of the FAS was designed to model the transmissibility response at three locations when exposed to vertical vibration from 10 to 60 Hz. Reasonable results were found at the ankle, midfoot, and toes in the natural standing position (mean-squared error (ε) = 0.471, 0.089, 0.047) and forward centre of pressure (COP) (ε = 0.539, 0.058, 0.057). However, when the COP is backward, the model does not sufficiently capture the transmissibility response at the ankle (ε = 1.09, 0.219, 0.039). This work was supported by a Natural Science and Engineering Council of Canada Discovery Grant [RGPIN/ 4252-2015].

Shoulder complex motion is a fundamental aspect of wheelchair locomotion. However, this motion is difficult to capture with skin marker methods due to soft tissue artefacts (Bourne et al., 2011). To overcome this issue, scapula locators (SL), which are external devices equipped with reflective markers and manually registered on the scapula, have been designed (Brochard et al. 2012) To track scapula motion, the SL first needs to be configured as to simultaneously palpate three anatomical landmarks of the scapula: the acromial angle, inferior angle and root of the scapular spine. For static poses, de Groot et al. (1997) and Jafarian Tangrood et al. (2020) studied the impact of palpation incertitude and inter-observer variability on scapula position reconstruction. They reported a scapula angle error in the range of 3.5 – 5 degrees. However, shoulder motions have not been studied yet and the angle error remains unpredictable. The issue raised in this study was to determine the impact of palpation errors of the scapula’s anatomical landmarks when configuring the SL on the reconstruction of a motion-tracking task. Four angles were studied through a constrained multibody kinematics optimization. The study used a Monte Carlo approach and a statistic analysis. This study was funded by the French National Research Agency (ANR-19-CE19-0007).

This paper investigates the complex time-dependent behavior of cortex tissue, under adiabatic condition, using a two-phase flow poroelastic model. Motivated by experiments and Biot’s consolidation theory, we tackle time-dependent uniaxial loading, confined and unconfined, with various geometries and loading rates from 1 μ m / s to 100 μ m / s . The cortex tissue is modeled as the porous solid saturated by two immiscible fluids, with dynamic viscosities separated by four orders, resulting in two different characteristic times. These are respectively associated to interstitial fluid and glial cells. The partial differential equations system is discretised in space by the finite element method and in time by Euler-implicit scheme. The solution is computed using a monolithic scheme within the open-source computational framework FEniCS. The parameters calibration is based on Sobol sensitivity analysis, which divides them into two groups: the tissue specific group, whose parameters represent general properties, and sample specific group, whose parameters have greater variations. Our results show that the experimental curves can be reproduced without the need to resort to viscous solid effects, by adding an additional fluid phase. Through this process, we aim to present multiphase poromechanics as a promising way to a unified brain tissue modeling framework in a variety of settings.

During manual wheelchair (MWC) locomotion, the user's upper limbs are subject to significant levels of stress and fatigue because the upper body is permanently engaged to propel the MWC and in all daily activities (van der Woude et al., 2001). This stress can lead to pain and wounds in the upper limbs which in turn may lead to difficulties in autonomy and social integration for MWC users. Suggesting adequate and accessible paths for urban locomotion to MWC users could be a way to reduce the loads sustained by the upper limbs for this population. Tools for suggesting accessible places have already been forwarded in several smartphone applications, but no solution is currently able to provide the best accessible path to move from one place to another. This primarily requires the definition of a quantitative criterion that can be linked to the user’ individual physical capacities In the literature, the physical difficulty of a situation is generally described using either the propelling torque (i.e. the torque acting at the wheel hub and that ensure the wheel rotation) or through the total force applied by the user on the handrim (Koontz et al., 2005; Richter et al., 2007). However, it is unknown if the ranking of the situation difficulty based on these two criteria are equivalent. Hence, the aim of this preliminary study was to evaluate the ranking of various environmental situations according to the two previous criteria: propelling torque and the handrim total force. This study was supported by the French National Agency (ANR-19-CE19-0007).

This paper aims at proposing an automatic method to design and adjust simplified muscle paths of a musculoskeletal model. These muscle paths are composed of straight lines described by a limited set of fixed active via points and an optimization routine is developed to place these via points on the model in order to fit moment arms and musculotendon lengths input data. The method has been applied to a forearm musculoskeletal model extracted from the literature, using theoretical input data as an example. Results showed that for 75% of the muscle set, the relative root-mean-square error between literature theoretical data and the results from optimized muscle path was under 29.23% for moment arms and of 1.09% for musculotendon lengths. These results confirm the ability of the method to automatically generate computationally efficient muscle paths for musculoskeletal simulations. Using only via points lowers computational expense compared to paths exhibiting wrapping objects. A proper balance between computational time and anatomical realism should be found to help those models being interpreted by practitioners.

The kinematics of the body center of mass (bCoM) may provide crucial information supporting the rehabilitation process of people with transfemoral amputation. The use of magneto-inertial measurement units (MIMUs) is promising as it may allow in-the-field bCoM motion monitoring. Indeed, bCoM acceleration might be obtained by fusing the estimated accelerations of body segments' centers of mass (sCoM), the formers being computed from the measured accelerations by segment-mounted MIMUs and the known relative position between each pair of MIMU and underlying sCoM. This paper investigates how erroneous identifications of MIMUs positions impact the accuracy of estimated 3D sCoM and bCoM accelerations in transfemoral amputee gait. Using an experimental design approach, 215 simulations of erroneous identifications of MIMUs positions (up to 0.02 m in each direction) were simulated over seven recorded gait cycles of one participant. MIMUs located on the trunk and sound lower limbs were shown to explain up to 77% of the variance in the accuracy of the estimated bCoM acceleration, presumably due to the higher mass and/or angular velocity of these segments during gait of lower-limb amputees. Therefore, a special attention should be paid when identifying the positions of MIMUs located on segments contributing the most to the investigated motion. Sensitivity of the estimated vertical body center of mass acceleration to erroneous identifications of MIMU positions in the anteroposterior (AP), mediolateral (ML), and vertical (V) directions, expressed in percentage of the total variance of the estimation accuracy.

Background The analysis of biomechanical parameters derived from the body center of mass (BCoM) 3D motion allows for the characterization of gait impairments in people with lower-limb amputation, assisting in their rehabilitation. In this context, magneto-inertial measurement units are promising as they allow to measure the motion of body segments, and therefore potentially of the BCoM, directly in the field. Finding a compromise between the accuracy of computed parameters and the number of required sensors is paramount to transfer this technology in clinical routine. Research question Is there a reduced subset of instrumented segments (BSN) allowing a reliable and accurate estimation of the 3D BCoM acceleration transfemoral amputees? Methods The contribution of each body segment to the BCoM acceleration was quantified in terms of weight and similarity in ten people with transfemoral amputation. First, body segments and BCoM accelerations were obtained using an optoelectronic system and a full-body inertial model. Based on these findings, different scenarios were explored where the use of one sensor at pelvis/trunk level and of different networks of segment-mounted sensors for the BCoM acceleration estimation was simulated and assessed against force plate-based reference acceleration. Results Trunk, pelvis and lower-limb segments are the main contributors to the BCoM acceleration in transfemoral amputees. The trunk and shanks BSN allows for an accurate estimation of the sagittal BCoM acceleration (Normalized RMSE ≤ 13.1 %, Pearson’s correlations r ≥ 0.86), while five segments are necessary when the 3D BCoM acceleration is targeted (Normalized RMSE ≤ 13.2 %, Pearson’s correlations r ≥ 0.91). Significance A network of three-to-five segments (trunk and lower limbs) allows for an accurate estimation of 2D and 3D BCoM accelerations. The use of a single pelvis- or trunk-mounted sensor does not seem advisable. Future studies should be performed to confirm these results where inertial sensor measured accelerations are considered.

International audience; Evaluation of muscle forces is relevant to understand walking strategies of amputated subjects. Such results could be implemented in finite element modelling to study the interaction between the residual limb and the socket by adding muscles to the model to improve pressure prediction at the interface. Further studies are needed to accurately estimate the percentage of vertical loads supported by the ischial support and to evaluate the results with, for example, EMG data.

Our group aims at proposing a protocol for evaluating the subject-specific risk for sacral pressure ulcer (PU). The idea is to model the way soft tissue will be deformed under the external pressure and to compute internal strains. It has been indeed showed that high strains can create deep tissue injuries (Ceelen et al., 2008). Because of the clinical constraints, we propose to use Ultrasound (US) to build the subject-specific biomechanical model of the sacral soft tissue as an alternative to 3D MR imaging (because of cost, time and accessibility). This paper focuses on the way such a subject-specific model will be designed and more specifically on the methodology we propose for estimating the constitutive parameters of the internal sacral soft tissue, namely the adipose tissue and the muscle. The values of these parameters have indeed a strong influence on the computed internal strains This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 811965.

Background Body Center Of Mass velocity assessment is a prerequisite for several applications in prosthetic control and rehabilitation monitoring. Force plate data integration is a promising alternative to full-body quantitative analysis of segmental kinematics to estimate the velocity. Still, it remains to be implemented and validated for people with transfemoral amputation. Methods Two methods were used (force plate based and pelvic markers based) for Body Center Of Mass velocity estimation in a clinical context. The two methods were comparatively assessed on overground walking data of eight people with transfemoral amputation in a laboratory equipped with a motion capture system and force plates compared to reference estimation derived from a full body segmental gait analysis. The ‘Methods’ agreement with the reference was quantified from the Bland and Altman procedure. Findings The estimation of Body Center Of Mass velocity from force plate data integration was considered acceptable in terms of limits of agreement. In addition, the hypotheses used to determine integration constants were evaluated and shown to be reasonable as far as the walking direction is well controlled. Interpretation Results demonstrate the possibility to use the force plate method to assess the Body Center Of Mass velocity of people with transfemoral amputation for straight walking on level ground. An estimation from the velocity of pelvic markers can also be a relevant alternative as soon as the walking velocity remains low. Further investigation will deal with the impact of the errors on the computation of derived parameters such as individual limb power.

Background Brachial plexus birth palsy remains a frequent condition and one of its treatments is to transfer the Latissimus Dorsi tendon to the infraspinatus muscle. The aim of this study was to analyse, for the first time, the three-dimensional kinematic effects of this operation on the upper limb joints during the five Mallet tasks and their correlation with clinical parameters. Methods Kinematic analysis was performed using an electromagnetic device. An Index of Improvement taking into account the angle in preop and postop, the reproducibility and the angle of a control group was developed. Three groups of patients were analysed: sixteen patients (mean: 10,5 years) for the reproducibility, thirty children (mean: 9,5 years) for the control group and ten patients (mean: 8 years 7 months) who were operated. Findings The humerothoracic and glenohumeral external rotations improved during the external rotation, the neck and the abduction tasks and worsened during the spine task. The glenohumeral external rotation worsened during the mouth task. The Humerothoracic abduction improved during the abduction and the neck tasks. The elbow flexion improved for the neck task. Differences were observed between patients and correlations were obtained between the Index of Improvement and clinical parameters. Interpretation Using kinematics allows to better analyse the evolution of joint angles after the latissimus dorsi transfer. The Index of Improvement allows to quickly analyse the effect of the operation for each angle and each patient. This effect depends on clinical parameters.

Finite element analysis (FEA) is a numerical modeling tool vastly employed in research facilities to analyze and predict load transmission between the human body and a medical device, such as a prosthesis or an exoskeleton. Yet, the use of finite element modeling (FEM) in a framework compatible with clinical constraints is hindered by, among others, heavy and time-consuming assessments of material properties. Ultrasound (U.S.) imaging opens new and unique opportunities for the assessment of in vivo material properties of soft tissues. Confident of these advances, a method combining a freehand U.S. probe and a force sensor was developed in order to compute the hyperelastic constitutive parameters of the soft tissues of the thigh in both relaxed (R) and contracted (C) muscles' configurations. Seven asymptomatic subjects were included for the experiment. Two operators in each configuration performed the acquisitions. Inverse FEM allowed for the optimization of an Ogden's hyperelastic constitutive model of soft tissues of the thigh in large displacement. The mean shear modulus identified for configurations R and C was, respectively, 3.2 ± 1.3 kPa and 13.7 ± 6.5 kPa. The mean alpha parameter identified for configurations R and C was, respectively, 10 ± 1 and 9 ± 4. An analysis of variance showed that the configuration had an effect on constitutive parameters but not on the operator.

The initial assessment and postoperative monitoring of patients with various abnormalities of the foot in clinical routine practice is primarily based on the analysis of radiographs taken in the weightbearing position. Conventional x-ray imaging, however, only provides a 2-dimensional projection of 3-dimensional (3D) bony structures, and the clinical parameters assessed from these images can be affected by projection biases. In the present work, we addressed this issue by proposing an accurate 3D reconstruction method of the foot in the weightbearing position from low-dose biplanar radiographs with clinical index measurement assessment for clinical routine practice. The accuracy of the proposed reconstruction method was evaluated for both shape and clinical indexes by comparing 3D reconstructions of 6 cadaveric adult feet from computed tomographic images and from biplanar radiographs. For the reproducibility study, 3D reconstructions from the biplanar radiographs of the foot of 6 able-bodied subjects were considered, with 2 observers repeating each measurement of anatomic landmarks 3 times. Baseline assessment of important 3D clinical parameters was performed on 17 subjects (34 feet; mean age 27.7, range 20 to 52 years). The average point to surface distance between the 3D stereoradiographic reconstruction and the computed tomographic scan-based reconstruction was 1 mm (range 0mm to 6mm). The selected radiographic landmarks were highly reproducible (95% confidence interval

International audience; Measurement of femur motion relative to the socket in gait in TF amputated patients can be a good indicator of prosthesis outcome. Our model, using low dose bi- planar radiography and motion capture, gives a prediction of femur motion (AA, EF, IER) in line with the sparse results found in the literature.

Successfully simulating tissue evolution in bone is of significant importance in predicting various biological processes such as bone remodeling, fracture healing and osseointegration of implants. Each of these processes involves in different ways the permanent or transient formation of different tissue types, namely bone, cartilage and fibrous tissues. The tissue evolution in specific circumstances such as bone remodeling and fracturing healing is currently able to be modeled. Nevertheless, it remains challenging to predict which tissue types and organization can develop without any a priori assumptions. In particular, the role of mechano-biological coupling in this selective tissue evolution has not been clearly elucidated. In this work, a multi-tissue model has been created which simultaneously describes the evolution of bone, cartilage and fibrous tissues. The coupling of the biological and mechanical factors involved in tissue formation has been modeled by defining two different tissue states: an immature state corresponding to the early stages of tissue growth and representing cell clusters in a weakly neo-formed Extra Cellular Matrix (ECM), and a mature state corresponding to well-formed connective tissues. This has allowed for the cellular processes of migration, proliferation and apoptosis to be described simultaneously with the changing ECM properties through strain driven diffusion, growth, maturation and resorption terms. A series of finite element simulations were carried out on idealized cantilever bending geometries. Starting from a tissue composition replicating a mid-diaphysis section of a long bone, a steady-state tissue formation was reached over a statically loaded period of 10,000 h (60 weeks). The results demonstrated that bone formation occurred in regions which are optimally physiologically strained. In two additional 1000 h bending simulations both cartilaginous and fibrous tissues were shown to form under specific geometrical and loading cases and cartilage was shown to lead to the formation of bone in a beam replicating a fracture healing initial tissue distribution. This finding is encouraging in that it is corroborated by similar experimental observations of cartilage leading bone formation during the fracture healing process. The results of this work demonstrate that a multi-tissue mechano-biological model of tissue evolution has the potential for predictive analysis in the design and implementations of implants, describing fracture healing and bone remodeling processes. Funding by the Fédération Francilienne deMécanique (Coup de pouce 2016) is acknowledged.

This research draws on the social identity approach to investigate group performance in face-to-face and virtual brainstorming settings. In particular, we display Social Identity Cues (SIC) on participants or on avatars to foster group membership. We compare four conditions in a factorial design: Brainstorming in Face-to-face or Virtual setting, With or Without SIC. Seventy-two students belonging to a population with a strong social identity participated in the experiment, using their traditional clothing as SIC. The results show that the presence of SIC led to increased creative performance both in face-to-face and virtual settings. SIC also increased group identification, but only in the virtual environment. These results highlight the potential of avatars to support teamwork in a meaningful way. Traditional clothing of a specific student group acts as social identity cues.Face-to-face and avatar-mediated electronic brainstorming are compared.Impact of social identity cues is examined in face-to-face and virtual groups.Social identity cues improved performance both in real and virtual settings.

Introduction: Achilles tendon is the most frequently ruptured tendon, but its optimal treatment is increasingly controversial. The mechanical properties of the healing tendon should be studied further. Shear waves elastography (SWE) measures the shear modulus, which is proven to be correlated to elastic modulus in animal tendons. The aim of our study was to study whether the shear moduli of human cadaveric Achilles tendon, given by SWE, were correlated with the apparent elastic moduli of those tendons given by tensile tests. Materials and methods: Fourteen cadaveric lower-limbs were studied. An elastographic study of the Achilles tendon (AT) was first done in clinical-like conditions. SWE was performed at three successive levels (0, 3 and 6 cm from tendon insertion) with elastographic probe oriented parallel to tendon fibers, blindly, for three standardized ankle positions (25° plantar flexion, neutral position, and maximal dorsal flexion). The mean shear moduli were collected through blind offline data-analysis. Then, AT with triceps were harvested. They were subjected to tensile tests. A continuous SWE of the Achilles tendon was performed simultaneously. The apparent elastic modulus was obtained from the experimental stress-strain curve, and correlation with shear modulus (given by SWE) was studied. Results: Average shear moduli of harvested AT, given by SWE made an instant before the tensile tests, were significantly correlated with shear moduli of the same AT made at the same level, previously in clinical-like condition (p < 0.05), only in neutral position. There was a statistical correlation (p < 0.005) and a correlation coefficient R² equal to 0.95 ± 0.05, between shear moduli (SWE) and apparent elastic moduli (tensile tests), for 11 tendons (3 tendons were inoperable due to technical error), before a constant disruption in the correlation curves. Discussion: We demonstrated a significant correlation between SWE of Achilles tendon performed in clinicallike conditions (in neutral position) and SWE performed in harvested tendon. We also found a correlation between SWE performed on harvested tendon and apparent elastic moduli obtained with tensile tests (for 11 specimens). As a consequence, we can suppose that SWE of AT in clinical-like conditions is related to tensile tests. To our knowledge, the ability of SWE to reliably assess biomechanical properties of a tendon or muscle was, so far, only demonstrated in animal models. Conclusion: SWE can provide biomechanical information of the human AT non-invasively.

The authors thank Joost Venrooij, Project Leader at the Max Planck Institute for Biological Cybernetics, for providing the experimental results obtained on SIMONA flight simulator (TU Delft). The paper reassesses the mechanism of biodynamical feedthrough coupling to helicopter body motion in lateral-roll helicopter tasks. An analytical bio-aeroelastic pilot–vehicle model is first developed and tested for various pilot's neuromuscular adaptions in the lateral/roll axis helicopter tasks. The results demonstrate that pilot can destabilize the low-frequency regressing lead-lag rotor mode; however he/she is destabilizing also the high-frequency advancing lag rotor mode. The mechanism of pilot destabilization involves three vicious energy circles, i.e. lateral-roll, flap-roll and flap-lag motions, in a very similar manner as in the air resonance phenomenon. For both modes, the destabilization is very sensitive to an increase of the steady state rotor coning angle that increases the energy transfers from flap to lag motion through Coriolis forces. The analytical linear time-invariant model developed in this paper can be also used to investigate designs proneness to lateral/roll aeroelastic rotorcraft–pilot couplings. This work was supported by the “Complex Mechanical Systems Dynamics” Chair – Airbus Group Foundation and the engineering school Arts et Metiers Paristech.

The closure of a human lung airway is modeled as an instability of a two-phase flow in a pipe coated internally with a Newtonian liquid. For a thick enough coating, the Plateau-Rayleigh instability creates a liquid plug which blocks the airway, halting distal gas exchange. Owing to a bifrontal plug growth, this airway closure flow induces high stress levels on the wall, which is the location of airway epithelial cells. A parametric numerical study is carried out simulating relevant conditions for human lungs, in either ordinary or pathological situations. Our simulations can represent the physical process from pre- to postcoalescence phases. Previous studies have been limited to precoalescence only. The topological change during coalescence induces a high level of stress and stress gradients on the epithelial cells, which are large enough to damage them, causing sublethal or lethal responses. We find that postcoalescence wall stresses can be in the range of 300% to 600% greater than precoalescence values and so introduce an important source of mechanical perturbation to the cells., National Institutes of Health (NIH)

International audience; Prosthetic sockets are custom-designed and are decisive for functionality and comfort of limbprosthesis. To ensure load transmission and stability, high interface stresses are applied. Several computermodels of the socket/residual limb assembly have been designed to identify critical stress accumulations thatmay induce discomfort or trauma. However, clinically relevant personalized Finite Element (FE) modelsrepresent a bottleneck. While material definition of tissues is critical for the evaluation of socket/tissuesinteractions, personalization of deep Soft Tissue (ST) material properties remains challenging. For clinicalpurpose, it has to be simple, in vivo and thus non-invasive. This work explores the feasibility of freehandultrasound with an inverse method for assessing mechanical properties of the ST of the thigh. To be relevantfor socket design, the residual strain from donning socket was simulated by compressing tissues (5% of initialcircumference).

International audience; Several kinematic chains of the upper limbs have been designed in musculoskeletal models to investigate various upper extremity activities, including manual wheelchair propulsion. The aim of our study was to compare the effect of an ellipsoid mobilizer formulation to describe the motion of the scapulothoracic joint with respect to regression-based models on shoulder kinematics, shoulder kinetics and computational time, during manual wheelchair propulsion activities. Ten subjects, familiar with manual wheelchair propulsion, were equipped with reflective markers and performed start-up and propulsion cycles with an instrumented field wheelchair. Kinematic data obtained from the optoelectronic system and kinetic data measured by the sensors on the wheelchair were processed using the OpenSim software with three shoulder joint modeling versions (ellipsoid mobilizer, regression equations or fixed scapula) of an upper-limb musculoskeletal model. As expected, the results obtained with the three versions of the model varied, for both segment kinematics and shoulder kinetics. With respect to the model based on regression equations, the model describing the scapulothoracic joint as an ellipsoid could capture the kinematics of the upper limbs with higher fidelity. In addition, the mobilizer formulation allowed to compute consistent shoulder moments at a low computer processing cost. Further developments should be made to allow a subject-specific definition of the kinematic chain.

The command of a microprocessor-controlled lower limb prosthesis classically relies on the gait mode recognition. Real time computation of the pose of the prosthesis (i.e., attitude and trajectory) is useful for the correct identification of these modes. In this paper, we present and evaluate an algorithm for the computation of the pose of a lower limb prosthesis, under the constraints of real time applications and limited computing resources. This algorithm uses a nonlinear complementary filter with a variable gain to estimate the attitude of the shank. The trajectory is then computed from the double integration of the accelerometer data corrected from the kinematics of a model of inverted pendulum rolling on a curved arc foot. The results of the proposed algorithm are evaluated against the optoelectronic measurements of walking trials of three people with transfemoral amputation. The root mean square error (RMSE) of the estimated attitude is around 3&deg, close to the Kalman-based algorithm results reported in similar conditions. The real time correction of the integration of the inertial measurement unit (IMU) acceleration decreases the trajectory error by a factor of 2.5 compared to its direct integration which will result in an improvement of the gait mode recognition.

This study deals with the problem of the least-weight design of a lattice structure subject to constraints of different nature. To face this problem, a general multi-scale optimisation procedure is proposed. This approach aims at optimising both global and local geometric parameters defining the shape of the representative volume element of the lattice at the mesoscopic scale. The optimisation procedure involves design requirements defined at different scales: geometric and manufacturing constraints are involved at the mesoscopic scale, whilst thermodynamic constraints on the positive definiteness of the stiffness tensor of the lattice (modelled as an equivalent homogeneous anisotropic medium) intervene at the macroscopic scale. Finally, since lattice structures usually undergo compressive loads, a requirement on the first local buckling load is considered too. The proposed approach is based on (a) the non-uniform rational basis splines curves theory to describe the shape of the struts composing the lattice, (b) the strain energy homogenisation technique of periodic media to perform the scale transition and (c) a special genetic algorithm to perform optimisation calculations. The optimised solutions provided by the presented method are characterised by a weight saving of about $$39\%$$ with slightly enhanced mechanical properties when compared to conventional octahedral lattice structures.