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Biomedical subjects

Idsart Kingma

Publications and source records attributed to Idsart Kingma.

At least 19 recordsLinked to original sources

Effects of EMG processing on biomechanical models of muscle joint systems: sensitivity of trunk muscle moments, spinal forces, and stability.

Biomechanical models are in use to estimate parameters such as contact forces and stability at various joints. In one class of these models, surface electromyography (EMG) is used to address the problem of mechanical indeterminacy such that individual muscle activation patterns are accounted for. Unfortunately, because of the stochastical properties of EMG signals, EMG based estimates of muscle force suffer from substantial estimation errors. Recent studies have shown that improvements in muscle force estimation can be achieved through adequate EMG processing, specifically whitening and high-pass (HP) filtering of the signals. The aim of this paper is to determine the effect of such processing on outcomes of a biomechanical model of the lumbosacral joint and surrounding musculature. Goodness of fit of estimated muscle moments to net moments and also estimated joint stability significantly increased with increasing cut-off frequencies in HP filtering, whereas no effect on joint contact forces was found. Whitening resulted in moment estimations comparable to those obtained from optimal HP filtering with cut-off frequencies over 250 Hz. Moreover, compared to HP filtering, whitening led to a further increase in estimated joint-stability. Based on theoretical models and on our experimental results, we hypothesize that the processing leads to an increase in pick-up area. This then would explain the improvements from a better balance between deep and superficial motor unit contributions to the signal.

Adult↗

Effect of a stiff lifting belt on spine compression during lifting.

STUDY DESIGN: An in vivo study on weightlifters. OBJECTIVES: To determine if and how a stiff back belt affects spinal compression forces in weightlifting. SUMMARY OF BACKGROUND DATA: In weightlifting, a back belt has been reported to enhance intraabdominal pressure (IAP) and to reduce back muscle EMG and spinal compression forces. METHODS: Nine experienced weightlifters lifted barbells up to 75% body weight while inhaling and wearing a belt, inhaling and not wearing a belt, and exhaling and wearing a belt. IAP, trunk muscle EMG, ground reaction forces, and kinematics were measured. An EMG-assisted trunk model, including IAP effects, was used to calculate spinal compression and shear forces and to reveal the contribution of back muscles, abdominal muscles, and IAP to moment generation. RESULTS: The belt reduced compression forces by about 10%, but only when inhaling before lifting. The moment generated by IAP increased when wearing a belt and inhaling, but this moment was small and the increase was largely negated by the flexing moment generated by abdominal muscles. CONCLUSIONS: Wearing a tight and stiff back belt while inhaling before lifting reduces spine loading. This is caused by a moment generated by the belt rather than by the IAP.

Abdominal Muscles↗

Three-dimensional bone kinematics in an anterior laxity test of the ankle joint.

Questions addressed in this in-vitro study are (1) what are the actual three-dimensional kinematics of talus and calcaneus during an anterior drawer test as performed with the quasi-static anterior ankle tester (QAAT) (2) does laxity measurement with the QAAT represent the true anterior translation of talus relative to the tibia? Simultaneous measurements were made with the QAAT and a three-dimensional kinematics analysis system in five specimens. The three-dimensional translations and rotations on three axes were analysed at 25, 50 and 100 N of applied anterior load, with increased ligament damage. For four out of five remaining specimens, anterior translation values of talus and calcaneus and values as measured with the QAAT show a significant increase with growing ligament damage and with higher loads. Skeletal motions of talus and calcaneus show great similarity in three different motion axes, with increased ligament damage and at any given load. Skeletal translations and rotations of talus and calcaneus show great similarity during an anterior drawer movement of the ankle joint. Anterior skeletal translation of the talus and calcaneus show fair correlation with the anterior displacements measurements of the QAAT. These QAAT measurements show an overestimation of the laxity value by more than 200% irrespective of the load applied.

Aged↗

Fatigue failure in shear loading of porcine lumbar spine segments.

STUDY DESIGN: An in vitro study on porcine spinal segments. OBJECTIVES: To determine the differences in mechanical behavior and fatigue strength in shear loading between intact spinal segments and segments without posterior elements, and between segments in neutral and flexed positions. SUMMARY OF BACKGROUND DATA: Limited data are available on shear strength of spinal segments. Literature suggests that shear loading can lead to failure of the posterior elements and failure of the disc, when the posterior elements cannot provide adequate protection. METHODS: In 2 experiments, 18 and 20 spines of pigs (80 kg) were used, respectively. Shear strength of the T13-L1 segment was tested, while loaded with 1600-N compression. L2-L3 and L4-L5 segments were loaded with a sinusoidal shear between 20% and 80% of the strength of the corresponding T13-L1 segment and 1600-N compression. In experiment No. 1, the posterior elements were removed in half the segments. In experiment No. 2, half the segments were tested in the neutral position, and half were tested in 10 degrees flexion. RESULTS: The group without posterior elements had failure earlier than the intact group. In the group without posterior element, stiffness increased on failure; in the intact group, it decreased. In experiment No. 2, no differences between groups were found. CONCLUSIONS: Repetitive shear loading can induce failure of porcine spinal segments, likely caused by fracture of the posterior elements, and, although repetitive anterior shear forces can also induce disc damage, this appears not to occur in intact segments, not even when flexed close to maximal.

Animals↗

Trunk muscle activation and associated lumbar spine joint shear forces under different levels of external forward force applied to the trunk.

High anterior intervertebral shear loads could cause low back injuries and therefore the neuromuscular system may actively counteract these forces. This study investigated whether, under constant moment loading relative to L3L4, an increased externally applied forward force on the trunk results in a shift in muscle activation towards the use of muscles with more backward directed lines of action, thereby reducing the increase in total joint shear force. Twelve participants isometrically resisted forward forces, applied at several locations on the trunk, while moments were held constant relative to L3L4. Surface EMG and lumbar curvature were measured, and an EMG-driven muscle model was used to calculate compression and shear forces at all lumbar intervertebral joints. Larger externally applied forward forces resulted in a flattening of the lumbar lordosis and a slightly more backward directed muscle force. Furthermore, the overall muscle activation increased. At the T12L1 to L3L4 joint, resulting joint shear forces remained small (less than 200N) because the average muscle force pulled backward relative to those joints. However, at the L5S1 joint the average muscle force pulled the trunk forward so that the increase in muscle force with increasing externally applied forward force caused a further rise in shear force (by 102.1N, SD=104.0N), resulting in a joint shear force of 1080.1N (SD=150.4N) at 50Nm moment loading. It is concluded that the response of the neuromuscular system to shear force challenges tends to increase rather than reduce the shear loading at the lumbar joint that is subjected to the highest shear forces.

Abdomen↗

Mechanical invariants are implicated in dynamic touch as a function of their salience in the stimulus flow.

The authors investigated the mechanical basis of length perception through dynamic touch using specially designed rods in which the various moments of mass distribution (mass, static moment, and rotational inertia) were varied independently. In a series of 4 experiments, exploration style and rod orientation were manipulated such that the relative salience of moments of mass distribution varied markedly. Results showed that perceived length was based on the most salient moments. The authors concluded that the notion of salience is crucial for understanding the implication of moments of mass distribution in length perception and that it should play a pivotal role in developing an encompassing theory of dynamic touch.

Adult↗

Improving EMG-based muscle force estimation by using a high-density EMG grid and principal component analysis.

The accuracy of predictions of muscle force based on electromyography (EMG) is an important issue in biomechanics and kinesiology. Since human skeletal muscles show a high diversity and heterogeneity in their fiber architecture, it is difficult to properly align electrodes to the muscle fiber direction. Against this background, we analyzed the effect of different bipolar configuration directions on EMG-based force estimation. In addition, we investigated whether principal component analysis (PCA) can improve this estimation. High-density surface-EMG from the triceps brachii muscle and the extension force of the elbow were measured in 11 subjects. The root mean square difference (RMSD) between predicted and measured force was determined. We found the best bipolar configuration direction to cause a 13% lower RMSD relative to the worst direction. Optimal results were obtained with electrodes aligned with the expected main muscle fiber direction. We found that PCA reduced RMSD by about 40% compared to conventional bipolar electrodes and by about 12% compared to optimally aligned multiple bipolar electrodes. Thus, PCA contributes to the accuracy of EMG-based estimation of muscle force when using a high-density EMG grid.

Algorithms↗

Can low back loading during lifting be reduced by placing one leg beside the object to be lifted?

BACKGROUND AND PURPOSE: Lifting technique could, through its effect on low back loading, affect the risk of developing low back pain. In this study, 2 lifting techniques (a straddle technique and a 1-leg kneeling technique), which aimed to reduce low back loading by placing one leg beside a load, were compared with stoop lifting and squat lifting with respect to their effect on low back loading. SUBJECTS: Twelve men with no history of low back pain participated in the study. METHODS: The subjects lifted wide and narrow 20-kg boxes from 2 initial hand heights. With measured kinematics, ground reaction forces, and electromyography, 3-dimensional spinal forces were calculated. RESULTS: When the subjects lifted a narrow box from a 290-mm height, peak L5-S1 compression forces were 5,060 (SD = 827), 3,980 (SD = 701), 4,208 (SD = 762), and 4,719 (SD = 1,015) N for the stoop, squat, straddle, and kneeling techniques, respectively. When the subjects lifted a wide box from 50 mm, spinal compression forces were much higher and distributed differently over lifting techniques: 5,926 (SD = 610), 6,868 (SD = 924), 6,472 (SD = 1,042), and 6,064 (SD = 968) N, respectively. DISCUSSION AND CONCLUSION: The authors conclude that no single lifting technique can be advised for all lifting conditions.

Adult↗

Flow-related mechanics of the intervertebral disc: the validity of an in vitro model.

STUDY DESIGN: An in vitro mechanical study on porcine motion segments. OBJECTIVES: To test the validity of in vitro studies of the flow-related mechanics of the intervertebral disc and, in particular, to investigate whether fluid flows back into the disc during unloading after a loading cycle. SUMMARY OF BACKGROUND DATA: In vivo studies show both the inflow and outflow of fluid in the intervertebral disc. The resistance to flow out of the disc is higher than to inflow. The fluid flow is regulated via unbalance between the external load and the osmotic pressure of the nucleus pulposus. MATERIALS: There were 8 porcine lumbar motion segments (without posterior elements) and 8 isolated discs tested in a physiologic saline bath (39 degrees C). The specimens were preloaded at 0.025 MPa for 15 minutes. Three 15-minute loading periods at 2.0 MPa were applied, each followed by an unloading period of 30 minutes. Loads, axial displacements, and nucleus pressure were recorded online. RESULTS: Over the 3 loading and unloading periods, all specimens showed a net loss of height and mass. The time series of specimen height during the 3 unloading periods showed virtually identical responses. The pressure in the nucleus decreased in the subsequent loading periods and showed no increase during unloading. CONCLUSION: The data show the limitations of an in vitro model for studying fluid flow-related intervertebral disc mechanics. During loading, outflow of fluid occurred, but inflow appears to be virtually absent during unloading. Poro-elastic behavior cannot be reproduced in an in vitro model.

Animals↗

Scaling of lifting forces in relation to object size in whole body lifting.

Subjects prepare for a whole body lifting movement by adjusting their posture and scaling their lifting forces to the expected object weight. The expectancy is based on visual and haptic size cues. This study aimed to find out whether lifting force overshoots related to object size cues disappear or persist over a number of repeated lifts. In addition, the influence of the degree of alternation between load sizes, and the influence of knowledge of actual object weights prior to the lifts, were investigated with regard to their effect on force overshoots. Four experiments were performed using a large and a small box, each of 8.4 kg weight, and varying degrees of alternation between boxes. In two of the experiments, subjects were informed about the weight of the objects, while in the other two experiments they were not informed about the weight of the objects. When boxes were lifted 15 times before switching to the other box, rapid diminishing of force scaling errors was observed. However, when boxes were alternated each lift or after three lifts, persisting force scaling overshoots were found in lifting the large box compared to the small one. When participants were given information regarding the actual object weight, force overshoots in the first pair of large and small box lifts were not different from overshoots in experiments where subjects were not informed about the weight of the objects. This shows that, for occupational lifting, risks related to force overshoots in lifting large objects can persist despite experience in lifting the objects and despite the use of labels indicating the weight of the objects.

Adult↗

Workload of window cleaners using ladders differing in rung separation.

The objective of the present study was to compare energetic workload, perceived exertion, perceived discomfort, safety, and mechanical load at lower limb joints among window cleaners during usage of extension ladders with 30 and 35 cm rung separation. Eleven healthy male professional window cleaners of short and tall stature participated in this study. No significant differences between 30 and 35 cm rung separation were observed for the energetic workload. Results concerning the perceived exertion, discomfort, and safety indicate that 35 cm rung separation is preferred. Based on the mechanical load at the hip, knee, and ankle during ascending and descending the ladder, 30 cm rung separation is preferable to 35 cm rung separation. It is advised to climb ladders with the knees inside the side rails of the ladder, but this seems only possible with 35 cm rung separation. Findings of the presents study suggest that overall, a 35 cm rung separation is marginally favourable while using extension ladders.

Adult↗

Orientation of tendons in vivo with active and passive knee muscles.

Tendon orientations in knee models are often taken from cadaver studies. The aim of this study was to investigate the effect of muscle activation on tendon orientation in vivo. Magnetic resonance imaging (MRI) images of the knee were made during relaxation and isometric knee extensions and flexions with 0 degrees , 15 degrees and 30 degrees of knee joint flexion. For six tendons, the orientation angles in sagittal and frontal plane were calculated. In the sagittal plane, muscle activation pulled the patellar tendon to a more vertical orientation and the semitendinosus and sartorius tendons to a more posterior orientation. In the frontal plane, the semitendinosus had a less lateral orientation, the biceps femoris a more medial orientation and the patellar tendon less medial orientation in loaded compared to unloaded conditions. The knee joint angle also influenced the tendon orientations. In the sagittal plane, the patellar tendon had a more anterior orientation near full extension and the biceps femoris had an anterior orientation with 0 degrees and 15 degrees flexions and neutral with 30 degrees flexions. Within 0 degrees to 30 degrees of flexion, the biceps femoris cannot produce a posterior shear force and the anterior angle of the patellar tendon is always larger than the hamstring tendons. Therefore, co-contraction of the hamstring and quadriceps is unlikely to reduce anterior shear forces in knee angles up to 30 degrees . Finally, inter-individual variation in tendon angles was large. This suggests that the amount of shear force produced and the potential to counteract shear forces by co-contraction is subject-specific.

Adult↗

Co-contraction during static and dynamic knee extensions in ACL deficient subjects.

Co-contraction of the muscles is proposed in the literature as one of the strategies that anterior cruciate ligament deficient (ACLD) subjects can use to compensate the loss of ACL function. This study examined the response of ACLD and control subjects to different shear forces in isometric and slow-dynamic knee extensions. Twelve chronic ACLD and 10 control subjects performed submaximal positioning and slow-dynamic knee extensions (between 45 degrees and 5 degrees of knee flexion) with two external flexion moments both applied at two distances on the lower leg. The shear force was controlled by changing the moment arm without changing the moment. Electromyographic data were collected from knee flexor and extensor muscles. In the analysis of variance, no significant effect of subject group was found in positioning or slow-dynamic tasks across all muscles. The effect of knee angle was significantly different between the subject groups for biceps femoris in positioning and for rectus femoris in slow-dynamic tasks, but these effects were very small and will not have a great impact on the resulting shear forces. There was no interaction between moment arm and subject group. Therefore, the hypothesis that ACLD subjects increase co-contraction in situations with an increased shear load in positioning and slow-dynamic knee extensions could not be confirmed.

Adult↗

Towards optimal multi-channel EMG electrode configurations in muscle force estimation: a high density EMG study.

Surface EMG is an important tool in biomechanics, kinesiology and neurophysiology. In neurophysiology the concept of high-density EMG (HD-EMG), using two dimensional electrode grids, was developed for the measurement of spatiotemporal activation patterns of the underlying muscle and its motor units (MU). The aim of this paper was to determine, with the aid of a HD-EMG grid, the relative importance of a number of electrode sensor configurations for optimizing muscle force estimation. Sensor configurations are distinguished in two categories. The first category concerns dimensions: the size of a single electrode and the inter electrode distance (IED). The second category concerns the sensor's spatial distribution: the total area from which signals are obtained (collection surface) and the number of electrodes per cm(2) (collection density). Eleven subjects performed isometric arm extensions at three elbow angles and three contraction levels. Surface-EMG from the triceps brachii muscle and the external force at the wrist were measured. Compared to a single conventional bipolar electrode pair, the force estimation quality improved by about 30% when using HD-EMG. Among the sensor configurations, the collection surface alone appeared to be responsible for the major part of the EMG based force estimation quality by improving it with 25%.

Adult↗

Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading.

This study investigated the effects of initial load height and foot placement instruction in four lifting techniques: free, stoop (bending the back), squat (bending the knees) and a modified squat technique (bending the knees and rotating them outward). A 2D dynamic linked segment model was combined with an EMG assisted trunk muscle model to quantify kinematics and low back loading in 10 subjects performing 19 different lifting movements, using 10.5 kg boxes without handles. When lifting from a 0.05 m height with the feet behind the box, squat lifting resulted in 19.9% (SD 8.7%) higher net moments (p < 0.001) and 17.0% (SD 13.2%) higher compression forces (p < 0.01) than stoop lifting. This effect was reduced to 12.8% (SD 10.7%) for moments and a non-significant 7.4% (SD 16.0%) for compression forces when lifting with the feet beside the box and it disappeared when lifting from 0.5 m height. Differences between squat and stoop lifts, as well as the interaction with lifting height, could to a large extent be explained by changes in the horizontal L5/S1 intervertebral joint position relative to the load, the upper body acceleration, and lumbar flexion. Rotating the knees outward during squat lifts resulted in moments and compression forces that were smaller than in squat lifting but larger than in stoop lifting. Shear forces were small ( < 300 N) at the L4/L5 joint and substantial (1100 - 1400 N) but unaffected by lifting technique at the L5/S1 joint. The present results show that the effects of lifting technique on low back loading depend on the task context.

Adult↗

Mechanical loading of the low back and shoulders during pushing and pulling activities.

The objective of this study was to quantify the mechanical load on the low back and shoulders during pushing and pulling in combination with three task constraints: the use of one or two hands, three cart weights, and two handle heights. The second objective was to explore the relation between the initial and sustained exerted forces and the mechanical load on the low back and shoulders. Detailed biomechanical models of the low back and shoulder joint were used to estimate mechanical loading. Using generalized estimating equations (GEE) the effects were quantified for exerted push/pull forces, net moments at the low back and shoulders, compressive and shear forces at the low back, and compressive forces at the glenohumeral joint. The results of this study appeared to be useful to estimate ergonomics consequences of interventions in the working constraints during pushing and pulling. Cart weight as well as handle height had a considerable effect on the mechanical load and it is recommended to maintain low cart weights and to push or pull at shoulder height. Initial and sustained exerted forces were not highly correlated with the mechanical load at the low back and shoulders within the studied range of the exerted forces.

Adult↗

Is the trunk movement more perturbed after an asymmetric than after a symmetric perturbation during lifting?

Low back injury is associated with sudden movements and loading. Trunk motion after sudden loading depends on the stability of the spine prior to loading and on the trunk muscle activity in response to the loading. Both factors are not axis-symmetric. Therefore, it was hypothesized that the effects on trunk dynamics would be larger after an asymmetric than after a symmetric perturbation. Ten subjects lifted a crate in which, prior to lifting, a mass was displaced to the front or to the side without the subjects being aware of this. Crate and subject movements, crate reaction forces and muscle activity were recorded. From this, the stability prior to the perturbation was estimated, and the trunk angular kinematics and moments at the lumbo-sacral joint were calculated. Both perturbations only minimally affected the trunk kinematics, although the stability of the spine prior to the lifting movement was higher in the sagittal plane than in the frontal plane. In both conditions the stability appeared to be sufficient to absorb the applied perturbation.

Adult↗

Are hamstrings activated to counteract shear forces during isometric knee extension efforts in healthy subjects?

The hamstring muscles have the potential to counteract anterior shear forces at the knee joint by co-contracting during knee extension efforts. Such a muscle recruitment pattern might protect the anterior cruciate ligament (ACL) by reducing its strain. In this study we investigated to what extent co-activation of the knee flexors during extension efforts is compatible with the hypothesis that this co-activation serves to counteract anterior tibial shear forces during isometric knee extension efforts in healthy subjects. To this aim, it is investigated whether co-activation varies with the required knee extension moment, with the knee joint angle, and with the position of the external flexing force relative to the knee joint. With unaltered moment and muscle activation, distal positioning of the flexing force on the tibia causes higher resultant (muscular plus external) forward shear forces at the knee as compared to proximal positioning. In ten subjects, knee flexor and extensor EMG was measured during a quasi-isometric positioning task for a range (5-50 degrees) of knee flexion angles. It was found that the co-activation of the knee flexors increased with the extension moment, but this increase was less than proportional (p<0.001). The extension moment increased 2.7 to 3.4 times, whereas the activation of Biceps Femoris and Semitendinosus increased only a factor 1.3 to 2.0 (joint angle dependent). Furthermore, a strong increase in co-activation was seen near full extension of the knee joint. The position of the external extension load on the tibia did not affect the level of co-contraction. It is argued that these results do not suggest a recruitment pattern that is directed at reduction of anterior shear forces in the knee joint during sub-maximal isometric knee extension efforts in healthy subjects.

Adaptation, Physiological↗