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    3754 results match your criteria Clinical Biomechanics [Journal]

    1 OF 76

    Gait termination on a declined surface in trans-femoral amputees: Impact of using microprocessor-controlled limb system.
    Clin Biomech (Bristol, Avon) 2018 May 30;57:35-41. Epub 2018 May 30.
    Division of Biomedical Engineering, School of Engineering, University of Bradford, BD7 1DP, UK. Electronic address:
    Background: Walking down ramps is a demanding task for transfemoral-amputees and terminating gait on ramps is even more challenging because of the requirement to maintain a stable limb so that it can do the necessary negative mechanical work on the centre-of-mass in order to arrest (dissipate) forward/downward velocity. We determined how the use of a microprocessor-controlled limb system (simultaneous control over hydraulic resistances at ankle and knee) affected the negative mechanical work done by each limb when transfemoral-amputees terminated gait during ramp descent.

    Methods: Eight transfemoral-amputees completed planned gait terminations (stopping on prosthesis) on a 5-degree ramp from slow and customary walking speeds, with the limb's microprocessor active or inactive. Read More

    External biomechanical constraints impair maximal voluntary grip force stability post-stroke.
    Clin Biomech (Bristol, Avon) 2018 Jun 5;57:26-34. Epub 2018 Jun 5.
    Biomechanics and Neural Control of Movement Lab, University of California, Davis School of Medicine, Northern California VA Health Care System, Sacramento, CA 95817, USA. Electronic address:
    Background: Grip strength is frequently measured as a global indicator of motor function. In clinical populations, such as hemiparesis post-stroke, grip strength is associated with upper-extremity motor impairment, function, and ability to execute activities of daily living. However, biomechanical configuration of the distal arm and hand may influence the magnitude and stability of maximal voluntary grip force and varies across studies. Read More

    The response of peripheral microcirculation to gravity-induced changes.
    Clin Biomech (Bristol, Avon) 2018 Jun 5;57:19-25. Epub 2018 Jun 5.
    Unit of Mathematics, Afeka Tel Aviv Academic College of Engineering, Tel Aviv, Israel.
    Background: The peripheral microcirculation supplies fresh blood to the small blood vessels, providing oxygen and nutrients to the tissues, removing waste, and maintaining normal homeostatic conditions. The goal of this study was to characterize the response of the peripheral microcirculation, in terms of blood flow and tissue oxygenation variables, to gravity-induced changes.

    Methods: The study included 20 healthy volunteers and the experiment involved monitoring central and peripheral variables with the right hand positioned at different heights. Read More

    Determining loads acting on the pelvis in upright and recumbent birthing positions: A case study.
    Clin Biomech (Bristol, Avon) 2018 May 24;57:10-18. Epub 2018 May 24.
    Department of Mechanical and Materials Engineering, Queen's University, 130 Stuart Street, Kingston, Ontario K7L 3N6, Canada. Electronic address:
    Background: The biomechanics of mothers' birthing positions and their impact on maternal and newborn health outcomes are poorly understood. Our objectives were to determine the loads applied to the female pelvis during dynamic movement that may occur during childbirth; findings are intended to inform clinical understanding and further research on birth positioning mechanics.

    Methods: An optical motion capture system and force platforms were used to collect upright and supine movement data from two pregnant and three non-pregnant participants. Read More

    Differences in neck surface electromyography, kinematics and pain occurrence during physiological neck movements between neck pain and asymptomatic participants. A cross-sectional study.
    Clin Biomech (Bristol, Avon) 2018 May 22;57:1-9. Epub 2018 May 22.
    School of Population Sciences and Health Services Research, Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, United Kingdom. Electronic address:
    Background: Neck pain has been associated with altered muscle activity and impaired kinematics. Patients frequently report pain during physiological neck movements. Previously, the average muscle activity during these movements has been measured. Read More

    Effects of diabetic peripheral neuropathy on gait in vascular trans-tibial amputees.
    Clin Biomech (Bristol, Avon) 2018 Jul 9;56:84-89. Epub 2018 May 9.
    Niigata University of Health and Welfare, 1398, Simami-cho, Niigata 950-3198, Japan.
    Background: Patients with diabetes often develop diabetic peripheral neuropathy, which is a distal symmetric polyneuropathy, so foot function on the non-amputated side is expected to affect gait in vascular trans-tibial amputees. However, there is little information on the kinematics and kinetics of gait or the effects of diabetic peripheral neuropathy in vascular trans-tibial amputees. This study aimed to clarify these effects, including the biomechanics of the ankle on the non-amputated side. Read More

    American Society of Biomechanics Clinical Biomechanics Award 2017: Non-anatomic graft geometry is linked with asymmetric tibiofemoral kinematics and cartilage contact following anterior cruciate ligament reconstruction.
    Clin Biomech (Bristol, Avon) 2018 Jul 10;56:75-83. Epub 2018 May 10.
    Department of Mechanical Engineering, University of Wisconsin - Madison, 1513 University Avenue, Madison, WI 53706, USA; Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, 1685 Highland Avenue, Madison, WI 53705, USA; Department of Biomedical Engineering, University of Wisconsin - Madison, 1415 Engineering Drive, Madison, WI 53706, USA. Electronic address:
    Background: Abnormal knee mechanics may contribute to early cartilage degeneration following anterior cruciate ligament reconstruction. Anterior cruciate ligament graft geometry has previously been linked to abnormal tibiofemoral kinematics, suggesting this parameter may be important in restoring normative cartilage loading. However, the relationship between graft geometry and cartilage contact is unknown. Read More

    Trunk forward flexion mobility in reference to postural sway in women after delivery: A prospective longitudinal comparison between early pregnancy and 2- and 6-month postpartum follow-ups.
    Clin Biomech (Bristol, Avon) 2018 Jul 19;56:70-74. Epub 2018 May 19.
    Department of Physiotherapy of the Nervous and Locomotor Systems, Academy of Physical Education, Katowice, Poland.
    Background: It has been documented that pregnancy-related increased connective tissue laxity may persist postpartum; however, it is still unclear for how long. This longitudinal study aimed to compare total trunk forward flexion mobility in women between their first trimester of pregnancy and at 2- and 6-month postpartum follow-ups. We also searched for a correlation between women's trunk flexibility and their postural stability in the sagittal plane. Read More

    Low-dimensional dynamical characterization of human performance of cancer patients using motion data.
    Clin Biomech (Bristol, Avon) 2018 Jul 18;56:61-69. Epub 2018 May 18.
    Department of Aerospace & Mechanical Engineering, University of Southern California, Los Angeles, CA 90089, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA; Department of Mathematics, University of Southern California, Los Angeles, CA 90089, USA.
    Background: Biomechanical characterization of human performance with respect to fatigue and fitness is relevant in many settings, however is usually limited to either fully qualitative assessments or invasive methods which require a significant experimental setup consisting of numerous sensors, force plates, and motion detectors. Qualitative assessments are difficult to standardize due to their intrinsic subjective nature, on the other hand, invasive methods provide reliable metrics but are not feasible for large scale applications.

    Methods: Presented here is a dynamical toolset for detecting performance groups using a non-invasive system based on the Microsoft Kinect motion capture sensor, and a case study of 37 cancer patients performing two clinically monitored tasks before and after therapy regimens. Read More

    Design and clinical outcome of a novel 3D-printed prosthetic joint replacement for the human temporomandibular joint.
    Clin Biomech (Bristol, Avon) 2018 Jul 11;56:52-60. Epub 2018 May 11.
    Department of Surgery, St Vincent's Hospital, Victoria, Australia.
    Background: Stock prosthetic temporomandibular joint replacements come in limited sizes, and do not always encompass the joint anatomy that presents clinically. The aims of this study were twofold. Firstly, to design a personalized prosthetic total joint replacement for the treatment of a patient's end-stage temporomandibular joint osteoarthritis, to implant the prosthesis into the patient, and assess clinical outcome 12-months post-operatively; and secondly, to evaluate the influence of changes in prosthetic condyle geometry on implant load response during mastication. Read More

    In-vivo stiffness assessment of distal femur fracture locked plating constructs.
    Clin Biomech (Bristol, Avon) 2018 Jul 21;56:46-51. Epub 2018 May 21.
    Stanford University School of Medicine, Stanford, CA, USA. Electronic address:
    Background: The purpose of this study was to design and validate a novel stiffness-measuring device using locked plating of distal femur fractures as a model.

    Methods: All patients underwent a laterally-based approach, with a bridging locked construct after indirect reduction. A custom and calibrated intraoperative stiffness device was applied and the stiffness of the construct was blindly recorded. Read More

    Comparative biomechanical study of a new transpedicular vertebral device and vertebroplasty for the treatment or prevention of vertebral compression fractures.
    Clin Biomech (Bristol, Avon) 2018 Jul 2;56:40-45. Epub 2018 May 2.
    Institute of Orthopaedic Research and Biomechanics, Trauma Research Center Ulm (ZTF), University Hospital Ulm, Germany.
    Background: A comparative study was performed between a novel transpedicular implant (V-STRUT©, Hyprevention, France) and vertebroplasty. This study aims to assess the biomechanical efficacy of this implant in resurrecting and fortifying the osteoporotic vertebra following a vertebral body fracture.

    Methods: A total of 17 vertebrae from 3 human osteoporotic spine segments (T9-L5) were selected. Read More

    Autologous bridging of rotator cuff tears with a hamstring tendon patch. A cadaver feasibility study and biomechanical testing.
    Clin Biomech (Bristol, Avon) 2018 Jul 19;56:36-39. Epub 2018 May 19.
    Department of Orthopaedics, University Hospital Hamburg-Eppendorf, Eppendorfer Landstrasse 60, 20249 Hamburg, Germany.

    Utility of cement injection to stabilize split-depression tibial plateau fracture by minimally invasive methods: A finite element analysis.
    Clin Biomech (Bristol, Avon) 2018 Jul 8;56:27-35. Epub 2018 May 8.
    Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France. Electronic address:
    Background: Treatment for fractures of the tibial plateau is in most cases carried out by stable fixation in order to allow early mobilization. Minimally invasive technologies such as tibioplasty or stabilization by locking plate, bone augmentation and cement filling (CF) have recently been used to treat this type of fracture. The aim of this paper was to determine the mechanical behavior of the tibial plateau by numerically modeling and by quantifying the mechanical effects on the tibia mechanical properties from injury healing. Read More

    A new methodology based on functional principal component analysis to study postural stability post-stroke.
    Clin Biomech (Bristol, Avon) 2018 Jul 5;56:18-26. Epub 2018 May 5.
    Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, Gascó Oliag street, 5, 46010, Valencia, Spain. Electronic address:
    Background: A major goal in stroke rehabilitation is the establishment of more effective physical therapy techniques to recover postural stability. Functional Principal Component Analysis provides greater insight into recovery trends. However, when missing values exist, obtaining functional data presents some difficulties. Read More

    Application of resampling techniques to improve the quality of survival analysis risk curves for human frontal bone fracture.
    Clin Biomech (Bristol, Avon) 2018 Apr 21. Epub 2018 Apr 21.
    Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, United States. Electronic address:
    Background: In automotive events, head injuries (skull fractures and/or brain injuries) are associated with head contact loading. While the widely-used head injury criterion is based on frontal bone fracture and linear accelerations, injury risk curves were not developed from original datasets.

    Objectives: Develop skull fracture-based risk curves for using previously published data and apply resampling techniques to assess their qualities. Read More

    Digital tracking algorithm reveals the influence of structural irregularities on joint movements in the human cervical spine.
    Clin Biomech (Bristol, Avon) 2018 Jul 26;56:11-17. Epub 2018 Apr 26.
    Department of Kinesiology, University of Waterloo, 200 University Avenue, Waterloo, ON N2L 3G1, Canada.
    Background: Disc height loss and osteophytes change the local mechanical environment in the spine; while previous research has examined kinematic dysfunction under degenerative change, none has looked at the influence of disc height loss and osteophytes throughout movement.

    Methods: Twenty patients with pain related to the head, neck or shoulders were imaged via videofluoroscopy as they underwent sagittal-plane flexion and extension. A clinician graded disc height loss and osteophytes as "severe/moderate", "mild", or "none". Read More

    Potential enhancement of articular cartilage histological grading with collagen integrity.
    Clin Biomech (Bristol, Avon) 2018 Jul 27;56:1-10. Epub 2018 Apr 27.
    School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Australia. Electronic address:
    Background: Histological evaluation of articular cartilage, such as using the Mankin scoring system, is the gold standard for characterization of tissue integrity. This scoring system takes into account several parameters indicative of the tissue's health; however, the collagen integrity, which is a primary indicator of cartilage health is not taken into consideration. Thus, there is need to enhance histological grading of articular cartilage by incorporating explicit scoring of collagen degeneration into the Modified Mankin grading system. Read More

    Bioabsorbable plating in the treatment of pediatric clavicle fractures: A biomechanical and clinical analysis.
    Clin Biomech (Bristol, Avon) 2018 Jun 30;55:94-99. Epub 2018 Apr 30.
    Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA; Division of Orthopedics, Rady Children's Hospital - San Diego, San Diego, CA, USA. Electronic address:
    Background: Classic implants for operative intervention of mid-shaft clavicle fractures in adolescents can become symptomatic, requiring removal. This study compares 1) biomechanical properties and 2) clinical outcomes in adolescents of mid-shaft clavicle fracture fixation with bioabsorbable versus metal implants.

    Methods: Six synthetic clavicles with mid-shaft fractures underwent bioabsorbable plating. Read More

    A novel helmet-mounted device for reducing the potential of catastrophic cervical spine fractures and spinal cord injuries in head-first impacts.
    Clin Biomech (Bristol, Avon) 2018 Apr 26. Epub 2018 Apr 26.
    Orthopaedic and Injury Biomechanics Group, Departments of Mechanical Engineering and Orthopaedics, International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada. Electronic address:
    Background: Head-first impacts with an aligned cervical spine cause some of the most severe types of injuries due to the risk of fractures and associated spinal cord injury. Sports, such as football, mountain biking and horseback riding, contribute to the incidence of spinal cord injury but there is potential to reduce the risk of these injuries through a helmet-mounted device.

    Methods: A novel device, the Pro-Neck-Tor mechanism, was incorporated into a commercial football helmet and tested in head-first impact experiments. Read More

    Examining upper limb kinematics and dysfunction of breast cancer survivors in functional dynamic tasks.
    Clin Biomech (Bristol, Avon) 2018 Jun 13;55:86-93. Epub 2018 Apr 13.
    Department of Kinesiology, University of Waterloo, Waterloo, Canada. Electronic address:
    Background: Comorbidities within the breast cancer population can reduce quality of life. Current breast cancer survivor upper limb kinematic strategies unfortunately lack robust connection with performing important activities of daily living.

    Methods: Accordingly, fifty breast cancer survivors performed 88 dynamic tasks (divided into range of motion-reach, range of motion-rotate, activity of daily living, and work tasks). Read More

    Cervical spine injury in rollover crashes: Anthropometry, excursion, roof deformation, and ATD prediction.
    Clin Biomech (Bristol, Avon) 2018 Apr 22. Epub 2018 Apr 22.
    University of Virginia Center for Applied Biomechanics, USA.
    While rollover crashes are rare, approximately one third of vehicle occupant fatalities occur in rollover crashes. Most severe-to-fatal injuries resulting from rollover crashes occur in the head or neck region, due to head and neck interaction with the roof during the crash. While many studies have used anthropomorphic test devices (ATDs) to predict head and neck injury, the biofidelity of ATDs in rollover has not been established. Read More

    Three-dimensional biomimetic head model as a platform for thermal testing of protective goggles for prevention of eye injuries.
    Clin Biomech (Bristol, Avon) 2018 Apr 22. Epub 2018 Apr 22.
    Heller Institute of Medical Research, Sheba Medical Center, Ramat Gan and the Sackler Faculty of Medicine, Tel Aviv University, Israel.
    Background: The rate of eye injury is steadily rising during military conflicts of the century, with thermal burns being the most common type of injury to the eyes. The present study focuses on assessing the heat resistance properties of military protective goggles using three-dimensional (3D) finite element head modeling fitted with the tested protective gear.

    Methods: A computational thermal impact was applied onto a 3D biomimetic human head model fitted with two goggle models - sports (Type 1) and square (Type 2). Read More

    Upper-limb biomechanical analysis of wheelchair transfer techniques in two toilet configurations.
    Clin Biomech (Bristol, Avon) 2018 Jun 12;55:79-85. Epub 2018 Apr 12.
    Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, PA, USA; Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address:
    Background: Using proper technique is important for minimizing upper limb kinetics during wheelchair transfers. The objective of the study was to 1) evaluate the transfer techniques used during toilet transfers and 2) determine the impact of technique on upper limb joint loading for two different toilet configurations.

    Methods: Twenty-six manual wheelchair users (23 men and 3 women) performed transfers in a side and front wheelchair-toilet orientation while their habitual transfer techniques were evaluated using the Transfer Assessment Instrument. Read More

    The trabecular effect: A population-based longitudinal study on age and sex differences in bone mineral density and vertebral load bearing capacity.
    Clin Biomech (Bristol, Avon) 2018 Jun 27;55:73-78. Epub 2018 Mar 27.
    Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States. Electronic address:
    Background: Approximately 16-24% of postmenopausal women are affected by vertebral fractures, negatively affecting their quality of life. Trabecular and cortical bones in vertebrae decline differently with age, thus having a distinct impact on vertebral failure loads. The purpose of this study was to investigate the effect of trabecular and cortical volumetric bone mineral density loss over time on estimated failure loads; and to evaluate the effect of sex and age. Read More

    Transfemoral amputee intact limb loading and compensatory gait mechanics during down slope ambulation and the effect of prosthetic knee mechanisms.
    Clin Biomech (Bristol, Avon) 2018 Jun 12;55:65-72. Epub 2018 Apr 12.
    VA Rehabilitation Research and Development Center for Limb Loss and Mobility, VA Puget Sound Health Care System, Seattle, WA, USA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
    Background: Intact limb knee osteoarthritis is a prevalent secondary disability in transfemoral amputees. Walking down a ramp may increase this risk due to excessive limb loading. We sought to determine whether intact limb loading differed between transfemoral amputees and controls during down slope ambulation, and the compensatory strategies transfemoral amputees used to modify intact limb loading. Read More

    Basic biomechanics of spinal cord injury - How injuries happen in people and how animal models have informed our understanding.
    Clin Biomech (Bristol, Avon) 2018 Apr 9. Epub 2018 Apr 9.
    International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada; Department of Mechanical Engineering, University of British Columbia, 6250 Applied Science Lane, Vancouver, BC V6T 1Z4, Canada; Department of Orthopaedics, University of British Columbia, 910 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada. Electronic address:
    The wide variability, or heterogeneity, in human spinal cord injury is due partially to biomechanical factors. This review summarizes our current knowledge surrounding the patterns of human spinal column injury and the biomechanical factors affecting injury. The biomechanics of human spinal injury is studied most frequently with human cadaveric models and the features of the two most common injury patterns, burst fracture and fracture dislocation, are outlined. Read More

    Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review.
    Clin Biomech (Bristol, Avon) 2018 Jun 11;55:53-64. Epub 2018 Apr 11.
    Department of Surgery and Cancer, Imperial College London, London, UK.
    Background: Currently, there is a widespread reliance on self-reported questionnaires to assess low back pain patients. However, it has been suggested that objective measures of low back pain patients' functional status should be used to aid clinical assessment. The aim of this study is to systematically review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures. Read More

    Bipedal hopping timed to a metronome to detect impairments in anticipatory motor control in people with mild multiple sclerosis.
    Clin Biomech (Bristol, Avon) 2018 Jun 13;55:45-52. Epub 2018 Apr 13.
    Recovery & Performance Laboratory, Faculty of Medicine, Memorial University, Canada. Electronic address:
    Background: People with mild multiple sclerosis (MS) often report subtle deficits in balance and cognition but display no measurable impairment on clinical assessments. We examined whether hopping to a metronome beat had the potential to detect anticipatory motor control deficits among people with mild MS (Expanded Disability Status Scale ≤ 3.5). Read More

    Effects of localized vibration on knee joint position sense in individuals with anterior cruciate ligament reconstruction.
    Clin Biomech (Bristol, Avon) 2018 Jun 14;55:40-44. Epub 2018 Apr 14.
    Biomechanics Laboratories, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States; Sports Medicine Center, Mayo Clinic, Rochester, MN, United States; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, United States. Electronic address:
    Background: Anterior cruciate ligament injury can disrupt one's mechanoreceptors and result in decreased proprioception such as joint position sense and ultimately altered motor function. The application of localized vibration has been used to investigate the integrity of the sensorimotor system and the mechanisms of quadriceps function after anterior cruciate ligament injury and reconstruction. The purpose of the study is to evaluate joint position sense with and without vibration and compare among anterior cruciate ligament reconstructed, contralateral, and control limbs. Read More

    Slip avoidance strategies in children with bilateral spastic cerebral palsy and crouch gait.
    Clin Biomech (Bristol, Avon) 2018 Jun 11;55:36-39. Epub 2018 Apr 11.
    Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milan, Italy. Electronic address:
    Background: A slip occurs when the required friction (RCOF) to prevent slipping at the foot/floor interfaces exceeds the available friction. The RCOF is dependent upon the biomechanics features of individuals and their gait. On the other hand, the available friction depends on environmental features. Read More

    Increased torsional stability by a novel femoral neck locking plate. The role of plate design and pin configuration in a synthetic bone block model.
    Clin Biomech (Bristol, Avon) 2018 Jun 27;55:28-35. Epub 2018 Mar 27.
    Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Pb. 1171 Blindern, 0318 Oslo, Norway.
    Background: In undisplaced femoral neck fractures, internal fixation remains the main treatment, with mechanical failure as a frequent complication. As torsional stable fixation promotes femoral neck fracture healing, the Hansson Pinloc® System with a plate interlocking pins, was developed from the original hook pins. Since its effect on torsional stability is undocumented, the novel implant was compared with the original configurations. Read More

    The influence of the twin peg design on femoral Interface temperature and maximum load to failure in cemented Oxford unicompartmental knee arthroplasty.
    Clin Biomech (Bristol, Avon) 2018 Jun 5;55:23-27. Epub 2018 Apr 5.
    Laboratory of Biomechanics and Implant Research, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany. Electronic address:
    Background: The twin peg femoral component was introduced for the cemented Oxford unicondylar knee to increase implant stability. The aim of this experimental study was to investigate the influence of the twin peg design on femoral interface temperature and maximum load to failure in comparison to the single peg design.

    Methods: In this experimental study medial Oxford unicompartmental knee arthroplasty was performed in 12 pairs of fresh-frozen human knees. Read More

    Posterior cervical spine crisscross fixation: Biomechanical evaluation.
    Clin Biomech (Bristol, Avon) 2018 Jun 4;55:18-22. Epub 2018 Apr 4.
    Department of Neurosurgery, Medical College of Wisconsin and Veterans Affairs Medical Center, Milwaukee, WI, United States.
    Background: Biomechanical/anatomic limitations may limit the successful implantation, maintenance, and risk acceptance of posterior cervical plate/rod fixation for one stage decompression-fusion. A method of posterior fixation (crisscross) that resolves biomechanical deficiencies of previous facet wiring techniques and not reliant upon screw implantation has been devised. The biomechanical performance of the new method of facet fixation was compared to the traditional lateral mass plate/screw fixation method. Read More

    Region-specific foot pain and plantar pressure in people with rheumatoid arthritis: A cross-sectional study.
    Clin Biomech (Bristol, Avon) 2018 Jun 4;55:14-17. Epub 2018 Apr 4.
    Health and Rehabilitation Research Institute, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, New Zealand. Electronic address:
    Background: It is unclear whether region-specific foot pain may influence plantar pressure in people with established rheumatoid arthritis. The aim was to determine the association between region-specific foot pain and region-specific plantar pressure.

    Methods: Twenty-one people with rheumatoid arthritis and 19 age- and sex-matched controls participated in this study. Read More

    Engineering approaches to understanding mechanisms of spinal column injury leading to spinal cord injury.
    Clin Biomech (Bristol, Avon) 2018 Mar 28. Epub 2018 Mar 28.
    Institute for Bone and Joint Research, Kolling Institute, Sydney Medical School, University of Sydney, Australia. Electronic address:
    Background: The mechanical interactions occurring between the spinal column and spinal cord during an injury event are complex and variable, and likely have implications for the clinical presentation and prognosis of the individual.

    Methods: The engineering approaches that have been developed to better understand spinal column and cord interactions during an injury event are discussed. These include injury models utilising human and animal cadaveric specimens, in vivo anaesthetised animals, finite element models, inanimate physical systems and combinations thereof. Read More

    Brain tissue strains vary with head impact location: A possible explanation for increased concussion risk in struck versus striking football players.
    Clin Biomech (Bristol, Avon) 2018 Mar 29. Epub 2018 Mar 29.
    MEA Forensic Engineers & Scientists, Richmond, BC, Canada; School of Kinesiology, University of British Columbia, Vancouver, BC, Canada. Electronic address:
    Background: On-field football helmet impacts over a large range of severities have caused concussions in some players but not in other players. One possible explanation for this variability is the struck player's helmet impact location.

    Methods: We examined the effect of impact location on regional brain tissue strain when input energy was held constant. Read More

    Influence of soft tissue in the assessment of the primary fixation of acetabular cup implants using impact analyses.
    Clin Biomech (Bristol, Avon) 2018 Jun 20;55:7-13. Epub 2018 Mar 20.
    CNRS, Laboratoire de Modélisation et de Simulation Multi-Echelle, UMR CNRS 8208, 61 Avenue du Général de Gaulle, Créteil 94010, France.
    Background: The acetabular cup (AC) implant primary stability is an important determinant for the success of cementless hip surgery but it remains difficult to assess the AC implant fixation in the clinic. A method based on the analysis of the impact produced by an instrumented hammer on the ancillary has been developed by our group (Michel et al., 2016a). Read More

    Headless compression screw for horizontal medial malleolus fractures.
    Clin Biomech (Bristol, Avon) 2018 Jun 27;55:1-6. Epub 2018 Mar 27.
    Stanford University School of Medicine, Stanford, CA, USA. Electronic address:
    Background: Horizontal medial malleolus fractures are caused by the application of rotational force through the ankle joint in several orientations. Multiple techniques are available for the fixation of medial malleolar fractures.

    Methods: Horizontal medial malleolus osteotomies were performed in eighteen synthetic distal tibiae and randomized into two fixation groups: 1) two parallel unicortical cancellous screws or 2) two Acutrak 2 headless compression screws. Read More


    Posterior or anterolateral approach in hip joint arthroplasty - Impact on frontal plane moment.
    Clin Biomech (Bristol, Avon) 2018 May 21;54:143-150. Epub 2018 Mar 21.
    Orthopaedic Research Unit, Aarhus University Hospital, Tage Hansensgade 2, Denmark; Department of Clinical Medicine, Aarhus University, Incuba/Skejby, bygning 2, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Aarhus, Denmark; Department of Orthopaedics, Aarhus University Hospital, Tage Hansens gade 2, 8000 Aarhus C, Denmark.
    Background: Anterolateral surgical approach in hip joint arthroplasty necessitates division of the hip abductor muscle complex, which may compromise postoperative gait observed in the frontal plane. The aim of the study was to compare frontal plane moment after hip joint arthroplasty by anterolateral or posterior approach and to explore which compensatory strategies patients use to decrease frontal plane moment.

    Methods: Twenty-eight patients were randomized by sealed envelopes to hip resurfacing arthroplasty surgery by anterolateral (ad modum Watson) or posterior (ad modum Moore) approach, performed by two senior surgeons. Read More

    Load transfer and periprosthetic fractures after total hip arthoplasty: Comparison of periprosthetic fractures of femora implanted with cementless distal-load or proximal-load femoral components and measurement of the femoral strain at the time of implantation.
    Clin Biomech (Bristol, Avon) 2018 May 21;54:137-142. Epub 2018 Mar 21.
    Department of Orthopedics, Klinikum Wels-Grieskirchen, Austria. Electronic address:
    Background: Little is known about the causes and mechanisms underlying periprosthetic fractures around femoral components particularly in relation to the stem design. In an in vitro study 20 pairs of fresh cadaveric femora were loaded to fracture axially and transversally.

    Findings: When proximal femoral strain was measured at the time of impaction of cementless stems the load transfer was determined by the underlying anatomy rather than by the shape of the stem, so that the so-called "load transfer" properties - proximal or distal - ascribed to stem designs are a myth. Read More

    Pullout strength of standard vs. cement-augmented rotator cuff repair anchors in cadaveric bone.
    Clin Biomech (Bristol, Avon) 2018 May 20;54:132-136. Epub 2018 Mar 20.
    Department of Orthopaedic Surgery, The Johns Hopkins University, 601 North Caroline Street, Baltimore, MD, USA. Electronic address:
    Background: We evaluate a novel method of rotator cuff repair that uses arthroscopic equipment to inject bone cement into placed suture anchors. A cadaver model was used to assess the pullout strength of this technique versus anchors without augmentation.

    Methods: Six fresh-frozen matched pairs of upper extremities were screened to exclude those with prior operative procedures, fractures, or neoplasms. Read More

    The influence of isolated femur and tibia rotations on patella cartilage stress: a sensitivity analysis.
    Clin Biomech (Bristol, Avon) 2018 May 12;54:125-131. Epub 2018 Mar 12.
    Jacquelin Perry Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA. Electronic address:
    Background: To determine the influence of femur and tibia rotations in the transverse and frontal planes on patella cartilage stress.

    Methods: Patella cartilage stress profiles of six healthy females were obtained during a squatting task using subject-specific finite element models of the patellofemoral joint (45° of knee flexion). Input parameters for the finite element model included joint geometry, quadriceps muscle forces, and weight-bearing patellofemoral joint kinematics. Read More

    Biomechanical analysis of the durability of a modified S1 vertebrae transpedicular screws insertion technique.
    Clin Biomech (Bristol, Avon) 2018 May 20;54:118-124. Epub 2018 Mar 20.
    Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Wroclaw University of Science and Technology, Lukasiewicza 7/9 Street, 50-371 Wrocław, Poland.
    Background: One of the most important elements of the transpedicular screw implantation technique, which enables a strong screw-bone interface, is the precise choice of the site of screw insertion and the screw's trajectory. Due to the complex biomechanics of the lumbosacral interface and different shape of the sacrum, fixation of this segment remains a challenge for surgeons. Because of this, Kubaszewski et al. Read More

    Three-dimensional kinematics of the cervical spine using an electromagnetic tracking device. Differences between healthy subjects and subjects with non-specific neck pain and the effect of age.
    Clin Biomech (Bristol, Avon) 2018 May 17;54:111-117. Epub 2018 Mar 17.
    Faculty of Medicine and Pharmacy, Department of Experimental Anatomy, Vrije Universiteit Brussel, 1090 Brussels, Belgium.
    Background: A cross-sectional observational study of three-dimensional cervical kinematics in 35 non-specific neck pain patients and 100 asymptomatic controls. To compare qualitative and quantitative aspects of cervical kinematics between healthy subjects and subjects with non-specific neck pain and to determine the effect of age on cervical kinematics in healthy subjects.

    Methods: Three-dimensional kinematics of active lateral bending and flexion-extension of 35 patients and 100 controls were registered by means of an electromagnetic tracking system. Read More

    Postural reconfiguration and cycle-to-cycle variability in patients with work-related musculoskeletal disorders compared to healthy controls and in relation to pain emerging during a repetitive movement task.
    Clin Biomech (Bristol, Avon) 2018 May 14;54:103-110. Epub 2018 Mar 14.
    Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria. Electronic address:
    Background: Movement variability in sustained repetitive tasks is an important factor in the context of work-related musculoskeletal disorders. While a popular hypothesis suggests that movement variability can prevent overuse injuries, pain evolving during task execution may also cause variability. The aim of the current study was to investigate, first, differences in movement behavior between volunteers with and without work-related pain and, second, the influence of emerging pain on movement variability. Read More

    Changes in total knee arthroplasty design affect in-vivo kinematics in a redesigned total knee system: A fluoroscopy study.
    Clin Biomech (Bristol, Avon) 2018 May 20;54:92-102. Epub 2018 Mar 20.
    Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy.
    Background: Journey II Bi-Cruciate-Stabilized knee system was designed to overcome the complications of Journey Bi-Cruciate-Stabilized, including ilio-tibial band inflammation and episodes of dislocation. The purpose of this study was to assess differences in knee kinematics between the first and second-generation design by means of video-fluoroscopy. Re-designed prosthesis in-vivo kinematics was analyzed during activities of daily living and results were eventually compared with those of the previous system, as reported in a previously published study. Read More

    Computer-assisted design and finite element simulation of braces for the treatment of adolescent idiopathic scoliosis using a coronal plane radiograph and surface topography.
    Clin Biomech (Bristol, Avon) 2018 May 14;54:86-91. Epub 2018 Mar 14.
    Polytechnique Montreal, P.O. Box 6079, Downtown Station, Montreal, Quebec H3C 3A7, Canada; Research Center, Sainte-Justine University Hospital Center, 3175, Cote Sainte-Catherine Road, Montreal, Quebec H3T 1C5, Canada. Electronic address:
    Background: Orthopedic braces made by Computer-Aided Design and Manufacturing and numerical simulation were shown to improve spinal deformities correction in adolescent idiopathic scoliosis while using less material. Simulations with BraceSim (Rodin4D, Groupe Lagarrigue, Bordeaux, France) require a sagittal radiograph, not always available. The objective was to develop an innovative modeling method based on a single coronal radiograph and surface topography, and assess the effectiveness of braces designed with this approach. Read More

    Defining the upper extremity range of motion for safe automobile driving.
    Clin Biomech (Bristol, Avon) 2018 May 15;54:78-85. Epub 2018 Mar 15.
    School of Public Health and Preventative Medicine, The Alfred Hospital, Commercial Rd, Melbourne, VIC 3004, Australia; The Avenue Hospital, 40 The Avenue, Windsor, VIC 3181, Australia.
    Background: There are no guidelines for return to driving following upper extremity injury. A greater comprehension of the role of the upper extremity in driving is required to assist clinicians in their fitness-to-drive assessments. This research aims to assist clinicians by analyzing the motion at the upper extremity in safe automobile driving. Read More

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