Compression-induced damage and internal tissue strains are related

Ceelen, KK Karlien; Stekelenburg, A Anke; Loerakker, Sandra; Strijkers, Gustav J.; Bader, Dan L.; Nicolay, Klaas; Baaijens, Fpt Frank; Oomens, C.W.J.

doi:10.1016/j.jbiomech.2008.09.016

Cited by 124 publications

(118 citation statements)

References 16 publications

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“…. , p (14) }, through which a smooth curve can be fitted (B). The source geometry for the socket is then formed by offsetting the region found under the curve by a desired thickness from the skin surface (C).…”

Section: G Controlling Design Featuresmentioning

confidence: 99%

“…[10]- [13]). In severe cases when loading conditions cause tissue deformation thresholds to be exceeded (see also [14] on thresholds), painful pressure ulcers may occur [15]; in some reports pressure ulcers have occurred in as high as 55% of subjects with major amputations [16]. However, even mild discomfort may be concerning as it could result in an altered posture and gait, which in turn may cause long term musculoskeletal conditions such as back pain [17].…”

Section: Introductionmentioning

confidence: 99%

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Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Moerman¹,

Sengeh²,

Herr³

2016

Preprint

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Abstract-Biomechanical interfaces are mechanical structures that form the connection between a device and a tissue region, and, through appropriate load transfer, aim to minimize tissue discomfort and injury. A patient-specific and data-driven computational framework for the automated design of biomechanical interfaces is presented here. Optimization of the design of biomechanical interfaces is complex since it is affected by the interplay of the geometry and mechanical properties of both the tissue and the interface. The proposed framework is presented for the application of transtibial amputee prostheses where the interface is formed by a prosthetic liner and socket. Conventional socket design and manufacturing is largely artisan, non-standard, and insufficiently data-driven, leading to discrepancies between the quality of sockets produced by different prosthetists. Furthermore, current prosthetic liners are often not patient-specific. The proposed framework involves: A) non-invasive imaging to record patient geometry, B) indentation to assess tissue mechanical properties, C) data-driven and automated creation of patientspecific designs, D) patient-specific finite element analysis (FEA) and design evaluation, and finally E) computer aided manufacturing. Uniquely, the FEA procedure controls both the design and mechanical properties of the devices, and simulates, not only the loading during use, but also the pre-load induced by the donning of both the liner and the socket independently. Through FEA evaluation, detailed information on internal and external tissue loading, which are directly responsible for discomfort and injury, are available. Further, these provide quantitative evidence on the implications of design choices, e.g. : 1) alterations in the design can be used to locally enhance or reduce tissue loading, 2) compliant features can aid in relieving local surface pressure. The proposed methods form a patient-specific, data-driven and repeatable design framework for biomechanical interfaces, and by enabling FEA-based optimization reduces the requirement for repeated patient involvement in the currently manual and iterative design process.

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Section: G Controlling Design Featuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Moerman¹,

Sengeh²,

Herr³

2016

Preprint

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“…These results substantiated the claim that epidermal indentation of such magnitude was responsible for the necrosis observed. A deformational threshold apparently existed beyond which damage increased with increasing maximum shear strain (114,115). …”

Section: Tissue Deformation and Internal Stressesmentioning

confidence: 99%

Biomechanics of Pressure Ulcer in Body Tissues Interacting with External Forces during Locomotion

Mak

Zhang²,

Tam

2010

Annu. Rev. Biomed. Eng.

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Forces acting on the body via various external surfaces during locomotion are needed to support the body under gravity, control posture, and overcome inertia. Examples include the forces acting on the body via the seating surfaces during wheelchair propulsion, the forces acting on the plantar foot tissues via the insole during gait, and the forces acting on the residual limb tissues via the prosthetic socket during various movement activities.Excessive exposure to unwarranted stresses at the body support interfaces could lead to tissue breakdowns commonly known as pressure ulcers, presented often as deep tissue injuries around bony prominences and/or surface damages on the skin. In this paper, we review the literatures on how the involved tissues respond to epidermal loadings, taking into account both experimental and computational findings from in-vivo and in-vitro studies. In particular, related literatures on internal tissue deformation and stresses, microcirculatory responses, as well as histological, cellular and molecular observations are discussed.

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“…9. Many current soft tissue loading devices for the MRI environment do not have dynamic force displacement control capabilities and have been limited to quasi-static deformation analysis [18,21,22,24,26,28,29], the evaluation of isotropic hyperelastic constitutive models [18,21,22,24,26,28,29], estimation of strain from 2D imaging [21,27,28] or from finite element simulations [21,22].…”

Section: Evaluation Of the System Mri Compatibilitymentioning

confidence: 99%

“…In addition the studies employing soft tissue loading devices have limited their analysis to the evaluation of isotropic hyperelastic constitutive models (e.g. [18,21,22,24,26,28,29]). Evaluation of more detailed constitutive models incorporating non-linearity, viscoelasticity and anisotropy require more detailed boundary condition measurement which is the focus of the current study.…”

Section: Introductionmentioning

confidence: 99%

A novel MRI compatible soft tissue indentor and fibre Bragg grating force sensor

Moerman

Sprengers

Nederveen

et al. 2013

Medical Engineering & Physics

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Compression-induced damage and internal tissue strains are related

Cited by 124 publications

References 16 publications

Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Automated and Data-driven Computational Design of Patient-Specific Biomechanical Interfaces

Biomechanics of Pressure Ulcer in Body Tissues Interacting with External Forces during Locomotion

A novel MRI compatible soft tissue indentor and fibre Bragg grating force sensor

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