Ground reaction forces and external hip joint moments predict in vivo hip contact forces during gait

Alves, Sónia A.; Polzehl, Jörg; Brisson, Nicholas M.; Bender, Alwina; Agres, Alison N.; Damm, Philipp; Duda, Georg N.

doi:10.1016/j.jbiomech.2022.111037

Cited by 12 publications

(5 citation statements)

References 54 publications

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“…Apart from insoles, very similar data might be collected from mechanical sensors embedded in orthoses [ 31 ] or implants [ 32 ]. Potentially, walking on a slope in these recordings changes the data in similar ways as described here.…”

Section: Discussionmentioning

confidence: 99%

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study

Wolff,

Steinheimer,

Warmerdam

et al. 2024

J Med Internet Res

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Background Monitoring of gait patterns by insoles is popular to study behavior and activity in the daily life of people and throughout the rehabilitation process of patients. Live data analyses may improve personalized prevention and treatment regimens, as well as rehabilitation. The M-shaped plantar pressure curve during the stance phase is mainly defined by the loading and unloading slope, 2 maxima, 1 minimum, as well as the force during defined periods. When monitoring gait continuously, walking uphill or downhill could affect this curve in characteristic ways. Objective For walking on a slope, typical changes in the stance phase curve measured by insoles were hypothesized. Methods In total, 40 healthy participants of both sexes were fitted with individually calibrated insoles with 16 pressure sensors each and a recording frequency of 100 Hz. Participants walked on a treadmill at 4 km/h for 1 minute in each of the following slopes: −20%, −15%, −10%, −5%, 0%, 5%, 10%, 15%, and 20%. Raw data were exported for analyses. A custom-developed data platform was used for data processing and parameter calculation, including step detection, data transformation, and normalization for time by natural cubic spline interpolation and force (proportion of body weight). To identify the time-axis positions of the desired maxima and minimum among the available extremum candidates in each step, a Gaussian filter was applied (σ=3, kernel size 7). Inconclusive extremum candidates were further processed by screening for time plausibility, maximum or minimum pool filtering, and monotony. Several parameters that describe the curve trajectory were computed for each step. The normal distribution of data was tested by the Kolmogorov-Smirnov and Shapiro-Wilk tests. Results Data were normally distributed. An analysis of variance with the gait parameters as dependent and slope as independent variables revealed significant changes related to the slope for the following parameters of the stance phase curve: the mean force during loading and unloading, the 2 maxima and the minimum, as well as the loading and unloading slope (all P<.001). A simultaneous increase in the loading slope, the first maximum and the mean loading force combined with a decrease in the mean unloading force, the second maximum, and the unloading slope is characteristic for downhill walking. The opposite represents uphill walking. The minimum had its peak at horizontal walking and values dropped when walking uphill and downhill alike. It is therefore not a suitable parameter to distinguish between uphill and downhill walking. Conclusions While patient-related factors, such as anthropometrics, injury, or disease shape the stance phase curve on a longer-term scale, walking on slopes leads to temporary and characteristic short-term changes in the curve trajectory.

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Section: Discussionmentioning

confidence: 99%

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study

Wolff,

Steinheimer,

Warmerdam

et al. 2024

J Med Internet Res

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“…In addition to monitoring the integration of the implant in the bone stock [11] and electrical stimulation of bone growth to increase fixation stability [12][13][14][15], recording the loading of the total hip implant in everyday life and physical activities are critical. This information may be crucial for the structural health monitoring of the implant, therapeutic purposes, self-reflection, and research such as further optimizing implants or validating musculoskeletal multibody systems [16][17][18][19]. However, resultant hip joint forces from everyday activities have only been recorded in situ in a few subjects with instrumented THRs equipped with strain gauges [20,21].…”

Section: Introductionmentioning

confidence: 99%

Monitoring of Hip Joint Forces and Physical Activity after Total Hip Replacement by an Integrated Piezoelectric Element

Geiger,

Bathel,

Spors

et al. 2024

Technologies

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Resultant hip joint forces can currently only be recorded in situ in a laboratory setting using instrumented total hip replacements (THRs) equipped with strain gauges. However, permanent recording is important for monitoring the structural condition of the implant, for therapeutic purposes, for self-reflection, and for research into managing the predicted increasing number of THRs worldwide. Therefore, this study aims to investigate whether a recently proposed THR with an integrated piezoelectric element represents a new possibility for the permanent recording of hip joint forces and the physical activities of the patient. Hip joint forces from nine different daily activities were obtained from the OrthoLoad database and applied to a total hip stem equipped with a piezoelectric element using a uniaxial testing machine. The forces acting on the piezoelectric element were calculated from the generated voltages. The correlation between the calculated forces on the piezoelectric element and the applied forces was investigated, and the regression equations were determined. In addition, the voltage outputs were used to predict the activity with a random forest classifier. The coefficient of determination between the applied maximum forces on the implant and the calculated maximum forces on the piezoelectric element was R2 = 0.97 (p < 0.01). The maximum forces on the THR could be determined via activity-independent determinations with a deviation of 2.49 ± 13.16% and activity-dependent calculation with 0.87 ± 7.28% deviation. The activities could be correctly predicted using the classification model with 95% accuracy. Hence, piezoelectric elements integrated into a total hip stem represent a promising sensor option for the energy-autonomous detection of joint forces and physical activities.

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“…Bone substitutes need to withstand complex stress environments, including loads different from the main axis of the unit structure. For example, the load on the hip joint varies with different movement patterns, and the direction of the load changes throughout the walking process. , As most porous bone scaffolds only test the mechanical properties in the uniaxial compression direction, there may still be a mismatch between the elastic modulus of the porous bone scaffold and the surrounding bone tissue, leading to issues such as bone absorption. Therefore, it is necessary to rotate TPMS units to study the elastic modulus and yield strength of porous scaffolds in different loading directions.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Properties Directionality and Permeability of Fused Triply Periodic Minimal Surface Porous Scaffolds Fabricated by Selective Laser Melting

Ye,

He,

Wei

et al. 2023

ACS Biomater. Sci. Eng.

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Titanium alloy porous scaffolds possess excellent mechanical properties and biocompatibility, making them promising for applications in bone tissue engineering. The integration of triply periodic minimal surface (TPMS) with porous scaffolds provides a structural resemblance to the trabecular and cortical bone structures of natural bone tissue, effectively reducing stress-shielding effects, enabling the scaffold to withstand complex stress environments, and facilitating nutrient transport. In this study, we designed fused porous scaffolds based on the Gyroid and Diamond units within TPMS and fabricated samples using selective laser melting technology. The effects of the rotation direction and angle of the inner-layer G unit on the elastic modulus of the fused TPMS porous scaffold were investigated through quasi-static compression experiments. Furthermore, the influence of the rotation direction and angle of the inner-layer G unit on the permeability, pressure, and flow velocity of the fused TPMS porous scaffold structure was studied using computational fluid dynamics (CFD) based on the Navier−Stokes model. The quasi-static compression experiment results demonstrated that the yield strength of the fused TPMS porous scaffold ranged from 367.741 to 419.354 MPa, and the elastic modulus ranged from 10.617 to 11.252 GPa, exhibiting stable mechanical performance in different loading directions. The CFD simulation results indicated that the permeability of the fused TPMS porous scaffold model ranged from 5.70015 × 10 −8 to 6.33725 × 10 −8 m 2 . It can be observed that the fused porous scaffold meets the requirements of the complex stress-bearing demands of skeletal structures and complies with the permeability requirements of human bone tissue.

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Ground reaction forces and external hip joint moments predict in vivo hip contact forces during gait

Cited by 12 publications

References 54 publications

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study

Monitoring of Hip Joint Forces and Physical Activity after Total Hip Replacement by an Integrated Piezoelectric Element

Mechanical Properties Directionality and Permeability of Fused Triply Periodic Minimal Surface Porous Scaffolds Fabricated by Selective Laser Melting

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