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Biomedical subjects

C D Mote

Publications and source records attributed to C D Mote.

At least 19 recordsLinked to original sources

In vivo finger flexor tendon force while tapping on a keyswitch.

Force may be a risk factor for musculoskeletal disorders of the upper extremity associated with typing and keying. However, the internal finger flexor tendon forces and their relationship to fingertip forces during rapid tapping on a keyswitch have not yet been measured in vivo. During the open carpal tunnel release surgery of five human subjects, a tendon-force transducer was inserted on the flexor digitorum superficialis of the long finger. During surgery, subjects tapped with the long finger on a computer keyswitch, instrumented with a keycap load cell. The average tendon maximum forces during a keystroke ranged from 8.3 to 16.6 N (mean = 12.9 N, SD = 3.3 N) for the subjects, four to seven times larger than the maximum forces observed at the fingertip. Tendon forces estimated from an isometric tendon-force model were only one to two times larger than tip force, significantly less than the observed tendon forces (p = 0.001). The force histories of the tendon during a keystroke were not proportional to fingertip force. First, the tendon-force histories did not contain the high-frequency fingertip force components observed as the tip impacts with the end of key travel. Instead, tendon tension during a keystroke continued to increase throughout the impact. Second, following the maximum keycap force, tendon tension during a keystroke decreased more slowly than fingertip force, remaining elevated approximately twice as long as the fingertip force. The prolonged elevation of tendon forces may be the result of residual eccentric muscle contraction or passive muscle forces, or both, which are additive to increasing extensor activity during the release phase of the keystroke.

Adult↗

Control strategies for finger movement during touch-typing. The role of the extrinsic muscles during a keystroke.

A single keystroke during touch-typing is a rapid, goal-directed motion of the fingertip which consists of two single-direction movements. The neural control and the role of the finger extrinsic musculature during typing have not yet been explained. The fingertip motion and force, and the intramuscular electromyographic (EMG) activity (fine-wire) of the index finger extrinsic musculature were measured during touch-typing by ten experienced typists. The motions and forces were repeatable qualitatively across keystrokes. A three-burst EMG pattern was observed during a single keystroke. The three bursts were: (1) a burst of extensor activity lifted the finger before the keystroke; (2) a burst of flexor activity followed while the fingertip was moving downward; and (3) a second burst of extensor activity occurred as the fingertip reached the end of key travel. The timing of the third burst suggests the role of the extensors is to remove the fingertip from the keyswitch rather than stop the downward motion of the finger. The collision with the end of key travel stops the downward finger motion. The timing of the finger flexor EMG activity, burst 2, suggests that the flexor contraction principally overcomes the activation force of the keyswitch rather than accelerates the finger downward as expected.

Adult↗

Tensions of the flexor digitorum superficialis are higher than a current model predicts.

Existing isometric force models can be used to predict tension in the finger flexor tendon, however, they assume a specific distribution of forces across the tendons of the fingers. These assumptions have not been validated or explored by experimental methods. To determine if the force distributions repeatably follow one pattern the in vivo tension of the flexor digitorum superficialis (FDS) tendon of the long finger was measured in nine patients undergoing open carpal tunnel release surgery. Following the release, a tendon force transducer (Dennerlein et al. 1997 J. Biomechanics 30(4), 395-397) was mounted onto the FDS of the long finger. Tension in the tendon, contact force at the fingertip, and finger posture were recorded while the patient gradually increased the force applied by the fingertip from 0 to 10 N and then monotonically reduced it to 0 N. The average ratio of the tendon tension to the fingertip contact force ranged from 1.7 to 5.8 (mean = 3.3, s.d. = 1.4) for the nine subjects. These ratios are larger than ratios predicted by current isometric tendon force models (mean = 1.2, s. d. = 0.4). Subjects who used a pulp pinch posture (hyper-extended distal interphalangeal joint (DIP)) showed a significantly (p = 0.02) larger ratio (mean = 4.4, s.d. = 1.5) than the five subjects who flexed the DIP joint in a tip pinch posture (mean = 2.4, s.d. = 0.6). A new DIP constraint model, which selects different force distribution based on DIP joint posture, predicts force ratios that correlate well with the measured ratios (r2 = 0.85).

Adult↗

A structural model of the forced compression of the fingertip pulp.

The fingertip pulp modulates the force transmitted to the underlying musculoskeletal system during finger contact on external bodies. A model of the fingertip pulp is needed to represent the transmission of forces to the tendons, muscles, and bone during these contacts. In this study, a structural model of the in vivo human fingertip was developed that incorporates both the material inhomogeneity and geometry. Study objectives were to determine (1) if this fingertip model can predict the force-displacement and force contact area responses of the in vivo human fingertip during contact with a flat, rigid surface, and (2) if the stresses and strains predicted by this model are consistent with the tactile sensing functionality of the in vivo human fingertip. The in vivo fingertip pulp was modeled as an inflated, ellipsoidal membrane, containing an incompressible fluid, that is quasi-statically compressed against a flat, frictionless surface. The membrane was assigned properties of skin (Veronda and Westmann, 1970) and when inflated, possessed dimensions approximating those of a human fingertip. Finite deformation was allowed. The model was validated by the pulp force-displacement relationship obtained by Serina et al. (1997) and by measurements of the contact area when the fingertip was pressed against a rigid surface with contact forces between 0.25 and 7.0 N. Model predictions represent the experimental data sufficiently well, suggesting that geometry, inhomogeneous material structure, and initial skin tension appear to represent the nonlinear response of the in vivo human fingertip pulp under compression. The predicted response of the fingertip pulp is consistent with its functionality as a tactile sensor.

Algorithms↗

A low profile human tendon force transducer: the influence of tendon thickness on calibration.

An in vitro calibration method for human tendon force transducers using tendon thickness to predict the calibration factor has been previously proposed (An et al., 1990, J. Biomechanics 23, 1269-1271). However, changes in the calibration factor due to changing tendon geometry during repeated tendon loading are unknown. A new, low-profile transducer design that measures tendon thickness in the transducer, in situ, is developed. An empirical model estimating the transducer's calibration factor is developed using data from in vitro tension testing of 12 fresh frozen human finger flexor tendons. Each tendon is preseated with ten loading cycles before data collection. Using tendon thickness, the model predicts the measured calibration factor to within 0-15% (average 6%). During repeated loading of an in vitro tendon, the calibration factor changes 15% over the first ten cycles (0-50 N) due to the observed changing tendon thickness. After the first ten loading cycles the variability of the calibration factor is reduced to less than 1% for the next three loading cycles. Hence this new, modified in vitro calibration procedure with tendon preseating reduces the cycle-to-cycle variability caused by the associated change in the tendon thickness.

Calibration↗

Force response of the fingertip pulp to repeated compression--effects of loading rate, loading angle and anthropometry.

Repeated loading of the fingertips has been postulated to contribute to tendon and nerve disorders at the wrist during activities associated with prolonged fingertip loading such as typing. To fully understand the pathomechanics of these soft tissue disorders, the role of the fingertip pulp in attenuating the applied dynamic forces must be known. An experiment was conducted to characterize the response of the in vivo fingertip pulp under repeated, dynamic, compressive loadings, to identify factors that influence pulp dynamics, and to better understand the force modulation by the pulp. Twenty subjects tapped repeatedly on a flat plate with their left index finger, while the contact force and pulp displacement were measured simultaneously. Tapping trials were conducted at three fingertip contact angles from the horizontal plane (0 degree, 45 degrees, and 90 degrees) and five tapping rates (0.25, 0.5, 1, 2, and 3 Hz). The fingertip pulp responds as a viscoelastic material, exhibiting rate-dependence, hysteresis, and a nonlinear force-displacement relationship. The pulp was relatively compliant at forces less than 1 N, but stiffened rapidly with displacement at higher forces for all loading conditions. This suggests that high-frequency forces of a small magnitude (< 1 N) are attenuated by the nonlinearly stiffening pulp while these forces of larger magnitude are transmitted to the bone. Pulp response was significantly influenced by the angle of loading. Fingertip dimensions, gender, and subject age had little to no influence on pulp parameters.

Adult↗

The prediction of metabolic energy expenditure during gait from mechanical energy of the limb: a preliminary study.

Measurements of metabolic energy consumption and free-walking velocity were recorded for four persons with trans-femoral amputation with variations of prosthesis mass and mass distribution. Hot-film anemometers, rate gyroscopes, and a force platform were used to measure prosthetic limb segment velocities and ground reaction forces. Metabolic energy consumption for the nine configurations of mass and mass distribution averaged 1.177 cal/kg/m with a standard deviation of +/- 0.052 cal/kg/m. Two measures of mechanical work of the amputated extremity, one based on power developed across joints (W1) and the other based on changes in energy of the body segments (W2), were computed to be 0.162 +/- 0.014 and 0.175 +/- 0.025 cal/kg/m, respectively. A linear regression model led to rejections of both W1 and W2 as predictors of metabolic energy expenditure of the amputee at a significance level of 0.05.

Aged↗

Femoral prosthesis implantation induces changes in bone stress that depend on the extent of porous coating.

The objective of this study was to evaluate the effect of implantation of porous-coated anatomic medullary fitting prostheses on stress in the proximal femur. Three-dimensional finite element models of a cadaveric femur before and after implantation were used to evaluate the resulting changes in stress in the bone. Models of the femur were generated automatically from computed tomographic scan data with use of an innovative mesh-generation technique. The models were analyzed for three levels of porous coating (proximal, 5/8, and full), with the assumption of ideal ingrowth (perfect bonding) over porous areas and a frictionless, tension-free surface on smooth areas. All models were loaded and restrained to represent conditions of normal gait. The stresses predicted in the implanted femur are consistent with clinical observations of proximal cortical atrophy (normal stress reduced to 6-9% of normal at the calcar and 50-55% at mid-prosthesis) and of hypertrophy at the porous coating junctions (normal stress at the 5/8-coating junction, 123% of stress proximal to the junction) and hypertrophy near the distal tip of the prosthesis (anterior and posterior normal stresses 200-800% of normal). The fully coated prosthesis induced stresses in the bone near the tip of the prosthesis that were most like stresses in the normal femur (medial and lateral normal stress 105 and 102% of the stress in the normal femur). Below the collar, the normal stress associated with the proximally coated prosthesis was 6% greater than that produced with the other two levels of coating but still was only 2% of normal. The 5/8-coated prosthesis appeared to combine the worst features of the fully coated and proximally coated prostheses--greater stress-shielding at the calcar and higher stress near the tip of the prosthesis.

Artificial Limbs↗

A method of measuring fingertip loading during keyboard use.

A single keycap on a standard alphanumeric computer keyboard was instrumented with a piezoelectric load cell and the fingertip motion was recorded with a high-speed video motion analysis system. Contact force histories between the fingertip and the keycap were recorded while four subjects typed a standard text for five minutes. Each keystroke force history is characterized by three distinct phases: (I) keyswitch compression, (II) finger impact and (III) fingertip pulp compression and release. Each keystroke force history contained two relative maxima, one in phase II and one in phase III. The subject mean peak forces ranged from 1.6 to 5.3 N and the subject mean peak fingertip velocities ranged from 0.3 to 0.7 m/s. Motion analyses and force measurements suggest a ballistic model of finger motion during typing.

Computer Terminals↗

Prediction of the loading along the leg during snow skiing.

The complete force and moment of each cross section of the leg between the ski boot top and the knee during normal skiing were predicted from measurements of the force and moment under the toe and heel of the boot and the flexion of the ankle. The force and moment components predicted at the base of the boot were significantly different from those predicted at sites of potential injury at the boot top and the knee. The maximum torsional and maximum varus-valgus moments predicted at the knee over all subjects tested were 70 Nm and 149 Nm, which are within the estimated range of the ultimate strength of the knee without support from contracted muscles crossing the knee. Regression analyses were used to find the force components at the base of the boot that best predict the bending and torsional moments at the boot top and knee. The torsional moments at the boot top and knee are best predicted by the medial-lateral force at the toe. The varus-valgus moment at the boot top and knee are best predicted by the resultant medial-lateral force component at the base of the boot. The set of best predictors of the anterior-posterior bending moments at the boot top and knee includes the vertical force at the toe, the vertical force at the heel and the component of the total vertical force directed perpendicular to the leg.

Adult↗

Use of hot wire anemometry to measure velocity of the limb during human movement.

Hot film anemometry, x-configuration probes were used in two experiments to evaluate their effectiveness at measurement of limb velocity. Data from tests with a probe attached to the end of a pendulum establish that the hot films measure velocity in the swing phase within 0.098 ms-1. The kinetic energy per unit mass of the pendulum was predicted within +/- 0.005 m2 s-2, from the measured velocity. In gait experiments with one human subject at speeds greater than 0.25 ms-1, the hot film anemometer and a video system predicted speeds within 0.083 ms-1. The hot film data are electronic signals that are easily stored and processed. The results from these experiments demonstrate that hot film anemometry is an effective and efficient method for direct measurement and analysis of the limb velocity.

Biophysical Phenomena↗

The effect of ankle constraint on the torsional laxity of the knee during internal-external rotation of the foot.

The in vivo torsional laxity and stiffness of the knee joint are usually determined by rotating the foot and measuring the torque generated at the knee. However, when rotation is applied to the foot, significant three-dimensional forces and moments are produced at the knee. These forces and moments depend upon the external constraint of the ankle complex, and as a result, the observed laxity of the knee also depends on the ankle constraint. Tests are conducted with the foot of a subject in a shoe, with and without the ankle taped, and in a buckled and unbuckled (ski) boot that can effectively constrain ankle rotation. The average laxity of the primary (linear) region of the axial moment vs internal-external rotation is 30% greater when the ankle is constrained by the buckled boot than it is in three other cases of lesser ankle constraint.

Adult↗

A finite helical axis as a landmark for kinematic reference of the knee.

Reference coordinates based on the finite helical axis for flexion of the knee from 0 to 90 deg are proposed. Six degree-of-freedom tracking allows the use of such a helical axis as a kinematic landmark for knee motion representation. Data from five human subjects in vivo are presented as a path of finite helical axes for flexion of the knee from 20 to 80 deg. The finite helical axis rotates by an average of 11.4 deg, the centrode translates an average of 19.8 mm, and the total axial translation averages 0.1 mm during flexion from 20 to 80 deg. Error due to the transducer was measured on a fixed-pivot pendulum and found to be 1.0 deg and 1.9 mm rms for the helical axis orientation and position, respectively, and 0.1 mm for the axial translation. Reproducibility and soft tissue effects on the measurements were repeatable to 4.0 deg and 2.7 mm rms in orientation and position, respectively, and 0.1 mm for the axial translations. Soft tissue errors averaged 4.9 deg and 3.6 mm in position and orientation, and 0.3 mm in the axial translations.

Adult↗

Automated three-dimensional finite element modelling of bone: a new method.

Three-dimensional finite element stress analysis of bone is a key to understanding bone remodelling, assessing fracture risk, and designing prostheses; however, the cost and complexity of predicting the stress field in bone with accuracy has precluded the routine use of this method. A new, automated method of generating patient-specific three-dimensional finite element models of bone is presented--it uses digital computed tomographic (CT) scan data to drive the geometry of the bone and to estimate its inhomogeneous material properties. Cubic elements of a user-specified size are automatically defined and then individually assigned the CT scan-derived material properties. The method is demonstrated by predicting the stress, stain, and strain energy in a human proximal femur in vivo. Three-dimensional loading conditions corresponding to the stance phase of gait were taken from the literature and applied to the model. Maximum principal compressive stresses of 8-23 MPa were computed for the medial femoral neck. Automated generation of additional finite element models with larger numbers of elements was used to verify convergence in strain energy.

Adult↗

Identification of a frequency response model of joint rotation.

A second order, linear oscillator transfer function model is fit to the measured transfer function relating the abduction-adduction rotation of the first finger to the applied moment. Nearly constant isometric contractions of the first palmar and dorsal interossei are maintained by the subjects during the measurements. The stiffness and damping components of the identified models increase significantly with increasing isometric contraction when compared to those recorded under relaxed contraction. Muscle fatigue causes the natural frequency, damping ratio and stiffness of the joint rotation to decrease under full isometric contraction, and it causes the natural frequency and stiffness to increase when the muscles are relaxed.

Action Potentials↗

A six-degree-of-freedom acoustic transducer for rotation and translation measurements across the knee.

An acoustic transducer design to measure the relative translations and rotations across the knee with no mechanical coupling between the tibia and femur is presented. Platforms attached to femoral and tibial tracking fixtures hold acoustic sources and receivers, respectively. The distance from each source to each receiver is measured by the acoustic transit time and the translations and rotations across the knee joint are computed. For rotations less than 30 deg around the expected operating position, the resolution of the transducer is 0.3 deg; for translations less than 1.5 cm around the expected operating position, the resolution is 0.03 cm. Theoretical error analysis using a Monte Carlo method shows that the uncertainty in the measurement depends on the relative position of the sources and receivers. The analysis predicts the worst case resolution of the transducer as 0.09 cm in translation and 0.6 deg in rotation when the receiver platform is translated 8.0 cm parallel to the source platform. The transducer and fixturing system are demonstrated on a cadaver specimen for applied anterior force and applied internal-external rotation. Errors due to (soft tissue) motion of the transducer relative to the bone during in vivo measurements are assessed on the cadaver specimen. For internal-external rotation the error due to soft tissue motion is a maximum of 0.5 cm in translation and 1.8 deg in rotation. For applied anterior force the error due to soft tissue motion is a maximum of 0.16 cm in translation and 2.7 deg in rotation.

Biomechanical Phenomena↗

Identification of knee joint models for varus-valgus and internal-external rotations: snow skiing experiments.

Sprains at the knee are the most frequent of the severe injuries occurring during alpine snow skiing. This paper discusses the development of analytical models describing rotations across the knee joint caused by varus-valgus and internal-external moments applied at the foot during skiing. Identification of an ARMAX model requires simultaneous measurements of the rotations across the knee and the moments at the foot during skiing. As the models only relate the measured input (moment) and output (rotation) data, they also identify components of apparent rotation resulting from imperfect fixation of the rotation measuring instrument on the test subject and resulting from other inputs. The models identified for all subjects are of order four or five for both varus-valgus and internal-external rotation, and they describe modes with oscillatory and exponentially decaying components. Application of the models to prediction of rotation across the knee from the measured moment at the foot is illustrated by example. A new, and virtually mechanically uncoupled, six degrees-of-freedom, strain gauge dynamometer is developed to record the moments at the foot during skiing. The concept of the dynamometer design has general application.

Humans↗

Prediction of fatigue failure of a total knee replacement tibial plateau using finite element analysis.

Recent reports of total knee prosthesis fractures have raised concerns over the long-term structural integrity of metal-backed tibial components. Both the development of a fibrous tissue membrane under the tibial plateau of a total knee prosthesis and loading conditions may seriously alter the fatigue life of the metal tibial tray. The effects of the cement and fibrous tissue at the bone-prosthesis interface were studied. Using the method of three-dimensional finite element analysis, peak loads of normal gait were simulated at several locations on the plateau of a generic, single-stemmed, porous-coated, CoCrMo tibial component model, providing information on the effect of abnormal loading patterns. According to the analysis, stresses below the material endurance limit are predicted throughout the prosthesis prior to the development of the fibrous membrane. However, stresses exceeding the yield strength of the material are predicted in a prosthesis that is supported by a fully developed 1 mm membrane, meaning that it has a markedly increased risk of low-cycle fatigue failure. Lateral displacement of the loading is detrimental to prosthesis life because maximum stress increases 100% while posterior displacement of the loading increases maximum stress by only 30%. Anterior loading creates stresses similar to those created by central loading. Because of their susceptibility to low-cycle fatigue failure, simple, single-stemmed prostheses are not recommended in cases of questionable bone stock unless modified. Several design alternatives are proposed.

Bone Cements↗