The influence of muscle activation on impact dynamics during lateral falls on the hip

Martel, Daniel; Levine, Iris C.; Pretty, Steven P.; Laing, Andrew C.

doi:10.1016/j.jbiomech.2017.11.002

Cited by 10 publications

(1 citation statement)

References 24 publications

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“… 3 Active muscular co-contraction around the hip during a fall controls the transfer of forces to the femur to some extent. 17 , 25 , 30 However, it remains challenging to both characterise the variability of muscle activation in a subject across all the falls they can encounter, as well as to model the influence of this activation on the mechanics of impact attenuation. Another contributor to impact force attenuation at the hip is passive attenuation.…”

Section: Introductionmentioning

confidence: 99%

Personalised 3D Assessment of Trochanteric Soft Tissues Improves HIP Fracture Classification Accuracy

et al. 2022

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Passive soft tissues surrounding the trochanteric region attenuate fall impact forces and thereby control hip fracture risk. The degree of attenuation is related to Soft Tissue Thickness (STT). STT at the neutral hip impact orientation, estimated using a regression relation in body mass index (BMI), was previously shown to influence the current absolute risk of hip fracture (ARF0) and its fracture classification accuracy. The present study investigates whether fracture classification using ARF0 improves when STT is determined from the subject’s Computed-Tomography (CT) scans (i.e. personalised) in an orientation-specific (i.e. 3D) manner. STT is calculated as the shortest distance along any impact orientation between a semi-automatically segmented femur surface and an automatically segmented soft tissue/air boundary. For any subject, STT along any of the 33 impact orientations analysed always exceeds the value estimated using BMI. Accuracy of fracture classification using ARF0 improves when using personalised 3D STT estimates (AUC = 0.87) instead of the BMI-based STT estimate (AUC = 0.85). The improvement is smaller (AUC = 0.86) when orientation-specificity of CT-based STT is suppressed and is nil when personalisation is suppressed instead. Thus, fracture classification using ARF0 improves when CT is used to personalise STT estimates and improves further when, in addition, the estimates are orientation specific.

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