Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 969

Search results for: soft knee

969 The Influence of Using Soft Knee Pads on Static and Dynamic Balance among Male Athletes and Non-Athletes

Authors: Yaser Kazemzadeh, Keyvan Molanoruzy, Mojtaba Izady

Abstract:

The balance is the key component of motor skills to maintain postural control and the execution of complex skills. The present study was designed to evaluate the impact of soft knee pads on static and dynamic balance of male athletes. For this aim, thirty young athletes in different sport fields with 3 years professional sport training background and thirty healthy young men nonathletic (age: 24.5 ± 2.9, 24.3 ± 2.4, weight: 77.2 ± 4.3 and 80/9 ± 6/3 and height: 175 ± 2/84, 172 ± 5/44 respectively) as subjects selected. Then, subjects in two manner (without knee and with soft knee pads made of neoprene) execute standard error test (BESS) to assess static balance and star test to assess dynamic balance. For analyze of data, t-tests and one-way ANOVA were significant 05/0 ≥ α statistical analysis. The results showed that the use of soft knee significantly reduced error rate in static balance test (p ≥ 0/05). Also, use a soft knee pads decreased score of athlete group and increased score of nonathletic group in star test (p ≥ 0/05). These findings, indicates that use of knees affects static and dynamic balance in athletes and nonathletic in different manner and may increased athletic performance in sports that rely on static balance and decreased performance in sports that rely on dynamic balance.

Keywords: static balance, dynamic balance, soft knee, athletic men, non athletic men

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968 The Effect of Impact on the Knee Joint Due to the Shocks during Double Impact Phase of Gait Cycle

Authors: Jobin Varghese, V. M. Akhil, P. K. Rajendrakumar, K. S. Sivanandan

Abstract:

The major contributor to the human locomotion is the knee flexion and extension. During heel strike, a huge amount of energy is transmitted through the leg towards knee joint, which in fact is damped at heel and leg muscles. During high shocks, although it is damped to a certain extent, the balance force transmits towards knee joint which could damage the knee. Due to the vital function of the knee joint, it should be protected against damage due to additional load acting on it. This work concentrates on the development of spring mass damper system which exactly replicates the stiffness at the heel and muscles and the objective function is optimized to minimize the force acting at the knee joint. Further, the data collected using force plate are put into the model to verify its integrity and are found to be in good agreement.

Keywords: spring, mass, damper, knee joint

Procedia PDF Downloads 180
967 The Osteocutaneous Distal Tibia Turn-over Fillet Flap: A Novel Spare-parts Orthoplastic Surgery Option for Functional Below-knee Amputation

Authors: Harry Burton, Alexios Dimitrios Iliadis, Neil Jones, Aaron Saini, Nicola Bystrzonowski, Alexandros Vris, Georgios Pafitanis

Abstract:

This article portrays the authors’ experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of “spares parts” in reconstructive microsurgery. This case describes a successful use of the osteocutaneous distal tibia turn-over fillet flap that allowed ‘lowering the level of the amputation’ from a through knee to the conventional level of a below-knee amputation to preserve the knee joint function. This case demonstrates the value of ‘spare-parts’ surgery principles and how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-over fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

Keywords: osteocutaneous flap, fillet flap, spare-parts surgery, Below knee amputation

Procedia PDF Downloads 35
966 Unpowered Knee Exoskeleton with Compliant Joints for Stair Descent Assistance

Authors: Pengfan Wu, Xiaoan Chen, Ye He, Tianchi Chen

Abstract:

This paper introduces the design of an unpowered knee exoskeleton to assist human walking by redistributing the moment of the knee joint during stair descent (SD). Considering the knee moment varying with the knee joint angle and the work of the knee joint is all negative, the custom-built spring was used to convert negative work into the potential energy of the spring during flexion, and the obtained energy work as assistance during extension to reduce the consumption of lower limb muscles. The human-machine adaptability problem was left by traditional rigid wearable due to the knee involves sliding and rotating without a fixed-axis rotation, and this paper designed the two-direction grooves to follow the human-knee kinematics, and the wire spring provides a certain resistance to the pin in the groove to prevent extra degrees of freedom. The experiment was performed on a normal stair by healthy young wearing the device on both legs with the surface electromyography recorded. The results show that the quadriceps (knee extensor) were reduced significantly.

Keywords: unpowered exoskeleton, stair descent, knee compliant joint, energy redistribution

Procedia PDF Downloads 56
965 A Review of Kinematics and Joint Load Forces in Total Knee Replacements Influencing Surgical Outcomes

Authors: Samira K. Al-Nasser, Siamak Noroozi, Roya Haratian, Adrian Harvey

Abstract:

A total knee replacement (TKR) is a surgical procedure necessary when there is severe pain and/or loss of function in the knee. Surgeons balance the load in the knee and the surrounding soft tissue by feeling the tension at different ranges of motion. This method can be unreliable and lead to early failure of the joint. The ideal kinematics and load distribution have been debated significantly based on previous biomechanical studies surrounding both TKRs and normal knees. Intraoperative sensors like VERASENSE and eLibra have provided a method for the quantification of the load indicating a balanced knee. A review of the literature written about intraoperative sensors and tension/stability of the knee was done. Studies currently debate the quantification of the load in medial and lateral compartments specifically. However, most research reported that following a TKR the medial compartment was loaded more heavily than the lateral compartment. In several cases, these results were shown to increase the success of the surgery because they mimic the normal kinematics of the knee. In conclusion, most research agrees that an intercompartmental load differential of between 10 and 20 pounds, where the medial load was higher than the lateral, and an absolute load of less than 70 pounds was ideal. However, further intraoperative sensor development could help improve the accuracy and understanding of the load distribution on the surgical outcomes in a TKR. A reduction in early revision surgeries for TKRs would provide an improved quality of life for patients and reduce the economic burden placed on both the National Health Service (NHS) and the patient.

Keywords: intraoperative sensors, joint load forces, kinematics, load balancing, and total knee replacement

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964 Virtual Test Model for Qualification of Knee Prosthesis

Authors: K. Zehouani, I. Oldal

Abstract:

Purpose: In the human knee joint, degenerative joint disease may happen with time. The standard treatment of this disease is the total knee replacement through prosthesis implanting. The reason lies in the fact that this phenomenon causes different material abrasion as compare to pure sliding or rolling alone. This study focuses on developing a knee prosthesis geometry, which fulfills the mechanical and kinematical requirements. Method: The MSC ADAMS program is used to describe the rotation of the human knee joint as a function of flexion, and to investigate how the flexion and rotation movement changes between the condyles of a multi-body model of the knee prosthesis as a function of flexion angle (in the functional arc of the knee (20-120º)). Moreover, the multi-body model with identical boundary conditions is constituted, and the numerical simulations are carried out using the MSC ADAMS program system. Results: It is concluded that the use of the multi-body model reduces time and cost since it does not need to manufacture the tibia and the femur as it requires for the knee prosthesis of the test machine. Moreover, without measuring or by dispensing with a test machine for the knee prosthesis geometry, approximation of the results of our model to a human knee is carried out directly. Conclusion: The pattern obtained by the multi-body model provides an insight for future experimental tests related to the rotation and flexion of the knee joint concerning the actual average and friction load.

Keywords: biomechanics, knee joint, rotation, flexion, kinematics, MSC ADAMS

Procedia PDF Downloads 60
963 The Low-Cost Design and 3D Printing of Structural Knee Orthotics for Athletic Knee Injury Patients

Authors: Alexander Hendricks, Sean Nevin, Clayton Wikoff, Melissa Dougherty, Jacob Orlita, Rafiqul Noorani

Abstract:

Knee orthotics play an important role in aiding in the recovery of those with knee injuries, especially athletes. However, structural knee orthotics is often very expensive, ranging between $300 and $800. The primary reason for this project was to answer the question: can 3D printed orthotics represent a viable and cost-effective alternative to present structural knee orthotics? The primary objective for this research project was to design a knee orthotic for athletes with knee injuries for a low-cost under $100 and evaluate its effectiveness. The initial design for the orthotic was done in SolidWorks, a computer-aided design (CAD) software available at Loyola Marymount University. After this design was completed, finite element analysis (FEA) was utilized to understand how normal stresses placed upon the knee affected the orthotic. The knee orthotic was then adjusted and redesigned to meet a specified factor-of-safety of 3.25 based on the data gathered during FEA and literature sources. Once the FEA was completed and the orthotic was redesigned based from the data gathered, the next step was to move on to 3D-printing the first design of the knee brace. Subsequently, physical therapy movement trials were used to evaluate physical performance. Using the data from these movement trials, the CAD design of the brace was refined to accommodate the design requirements. The final goal of this research means to explore the possibility of replacing high-cost, outsourced knee orthotics with a readily available low-cost alternative.

Keywords: 3D printing, knee orthotics, finite element analysis, design for additive manufacturing

Procedia PDF Downloads 88
962 Effect of Horizontal Joint Reinforcement on Shear Behaviour of RC Knee Connections

Authors: N. Zhang, J. S. Kuang, S. Mogili

Abstract:

To investigate seismic performance of beam-column knee joints, four full-scale reinforced concrete beam-column knee joints, which were fabricated to simulate those in as-built RC frame buildings designed to ACI 318-14 and ACI-ASCE 352R-02, were tested under reversed cyclic loading. In the experimental programme, particular emphasis was given to the effect of horizontal reinforcement (in format of inverted U-shape bars) on the shear strength and ductility capacity of knee joints. Test results are compared with those predicted by four seismic design codes, including ACI 318-14, EC8, NZS3101 and GB50010. It is seen that the current design codes of practice cannot accurately predict the shear strength of seismically designed knee joints.

Keywords: large-scale tests, RC beam-column knee joints, seismic performance, shear strength

Procedia PDF Downloads 182
961 The Existence of a Sciatic Artery in Congenital Lower Limb Deformities

Authors: Waseem Al Talalwah, Shorok Al Dorazi, Roger Soames

Abstract:

Persistent sciatic artery is a rare anatomical vascular variation resulting from a lack of regression of the embryonic dorsal axial artery. The axial artery is the main artery supplying the lower limb during development in the first trimester. The current research includes 206 sciatic artery cases in 171 patients between 1864 and 2012. It aims to identify the risk factor of sciatic artery aneurysm in congenital limb anomalies. Sciatic artery aneurysm was diagnosed incidentally in amniotic band syndrome (ABS) existing with no congenital anomaly in 0.7% or with double knee in 0.7%, with the tibia in 0.7% and with hemihypertrophy or soft tissue hypertrophy in 1.4%. Therefore, the current study indicates a relationship the same gene responsible for the congenital limb deformities may be responsible for non-regression of the sciatic artery. Furthermore, pediatricians should refer cases of congenital limb anomalies for vascular evaluation prior to corrective surgical intervention.

Keywords: amniotic band syndrome, congenital limb deformities, double knee, sciatic artery, sciatic artery aneurysm , soft tissue hypertrophy

Procedia PDF Downloads 123
960 The Various Forms of a Soft Set and Its Extension in Medical Diagnosis

Authors: Biplab Singha, Mausumi Sen, Nidul Sinha

Abstract:

In order to deal with the impreciseness and uncertainty of a system, D. Molodtsov has introduced the concept of ‘Soft Set’ in the year 1999. Since then, a number of related definitions have been conceptualized. This paper includes a study on various forms of Soft Sets with examples. The paper contains the concepts of domain and co-domain of a soft set, conversion to one-one and onto function, matrix representation of a soft set and its relation with one-one function, upper and lower triangular matrix, transpose and Kernel of a soft set. This paper also gives the idea of the extension of soft sets in medical diagnosis. Here, two soft sets related to disease and symptoms are considered and using AND operation and OR operation, diagnosis of the disease is calculated through appropriate examples.

Keywords: kernel of a soft set, soft set, transpose of a soft set, upper and lower triangular matrix of a soft set

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959 A Knee Modular Orthosis Design Based on Kinematic Considerations

Authors: C. Copilusi, C. Ploscaru

Abstract:

This paper addresses attention to a research regarding the design of a knee orthosis in a modular form used on children walking rehabilitation. This research is focused on the human lower limb kinematic analysis which will be used as input data on virtual simulations and prototype validation. From this analysis, important data will be obtained and used as input for virtual simulations of the knee modular orthosis. Thus, a knee orthosis concept was obtained and validated through virtual simulations by using MSC Adams software. Based on the obtained results, the modular orthosis prototype will be manufactured and presented in this article.

Keywords: human lower limb, children orthoses, kinematic analysis, knee orthosis

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958 Application of Soft Sets to Non-Associative Rings

Authors: Inayatur Rehman

Abstract:

Molodtstove developed the theory of soft sets which can be seen as an effective tool to deal with uncertainties. Since the introduction of this concept, the application of soft sets has been restricted to associative algebraic structures (groups, semi groups, associative rings, semi-rings etc.). Acceptably, though the study of soft sets, where the base set of parameters is a commutative structure, has attracted the attention of many researchers for more than one decade. But on the other hand there are many sets which are naturally endowed by two compatible binary operations forming a non-associative ring and we may dig out examples which investigate a non-associative structure in the context of soft sets. Thus it seems natural to apply the concept of soft sets to non-commutative and non-associative structures. In present paper, we make a new approach to apply Molodtsoves notion of soft sets to LA-ring (a class of non-associative ring). We extend the study of soft commutative rings from theoretical aspect.

Keywords: soft sets, LA-rings, soft LA-rings, soft ideals, soft prime ideals, idealistic soft LA-rings, LA-ring homomorphism

Procedia PDF Downloads 361
957 Mechanical Responses to Hip Versus Knee Induced Muscle Fatigue in Patellofemoral Pain Syndrome

Authors: Eman Ahmed Ahmed, Ghada Abdelmoneim Mohamed, Hamada Ahmed Hamada, Nagui Sobhi Nassif

Abstract:

Impaired skeletal muscle endurance may be an important causal factor in the development of patellofemoral pain syndrome (PFPS). However, there is lack of information regarding the effect of hip versus knee muscle fatigue on isokinetic parameters, and myoelectric activity of hip and knee muscles in these patients. Purpose: The study was conducted to investigate the effect of hip abductors versus knee extensors fatigue protocol on knee proprioception, hip and knee muscle strength and their myoelectric activity in patients with PFPS. Methods: Fifteen female patients with PFPS participated in the study. They were tested randomly under two fatiguing conditions; hip abductors and knee extensors fatigue protocols. Isolated muscle fatigue of two muscles was induced isokinetically on the affected side in a two separate sessions with a rest interval of at least three days. After determining peak torque, patients performed continuous maximal concentric-eccentric contraction of the selected muscle until the torque output dropped below 50% of peak torque value for 3 consecutive repetitions. Knee proprioception, eccentric hip abductors' peak torque, eccentric knee extensors' peak torque, EMG ratio of vastus medialis obliquus (VMO) / vastus lateralis (VL), and EMG activity of gluteus medius (GM) muscle, were recorded before and immediately after each fatigue protocol using the Biodex Isokinetic system and EMG Myosystem. Results: Two-way within subject MANOVA revealed that eccentric knee extensors’ peak torque decreased significantly after hip abductors fatigue protocol compared to pre fatigue condition (p<0.05). On the other hand, there was no statistically significant difference in the eccentric hip abductors’ peak torque after admitting knee extensors fatigue protocol (p > 0.05). Moreover, no significant difference was found in knee proprioception, EMG ratio of VMO/VL, and EMG activity of GM muscle, after either hip or knee fatigue protocol (p>0.05). Conclusion: A hip focused rehabilitation program may be beneficial in improving knee function through correcting faulty kinematics and hence decrease knee loading in patients with PFPS.

Keywords: electromyography, knee proprioception, mechanical responses, muscle fatigue, patellofemoral pain syndrome

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956 Scoliosis Effect towards of Incidence of the Secondary Osteoarthritis on the Knee in Athletes at the National Sports Cibubur Hospital on July 2013-April 2014

Authors: Basuki Supartono, Nunuk Nugrohowati, Ryan Gamma Andiraldi

Abstract:

Osteoarthritis of the knee can occur due to scoliosis. The purpose of this study is to determine the effect of scoliosis cause secondary osteoarthritis on the knee. This research use an analytic cross-sectional design. The total sample of 92 athletes scoliosis taken by simple random sampling technique. The data obtained were analyzing with Chi-square test, Fisher and Prevalence Ratio. The results of analysis show that there are influences on the incidence of scoliosis secondary osteoarthritis on the knee in athletes at the National Sports Hospital. Based on the criteria in the Cobbs angle had the results (p = 0.022 (p <0.05)), moderate Cobbs angle degree were 7.5 times more at risk of causing secondary osteoarthritis on the knee than a mild degree. While the shape of the curve scoliosis is getting results (p = 0.038 (p <0.05)), the shape of the S curve scoliosis 3.2 times more at risk of causing secondary osteoarthritis on the knee than the curve C. It can be concluded that there is significant influence between the Cobbs angle, shape of the curve scoliosis on the incidence of secondary osteoarthritis on the knee in National Sports Cibubur Hospital on July 2013- April 2014

Keywords: Cobbs angle, curve shape scoliosis, secondary osteoarthritis on the knee, analytic cross-sectional design

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955 Kinematic Analysis of Heel Height Effect on Knee Direction Correction in a Patient with Genu Recurvatum: A Case Study

Authors: Parya Salimitari, Farhad Tabatabai Ghomsheh, Siyamak Khorramymehr, Hossein Taghadosi, Mohammad Hossein Dashti

Abstract:

The aim of this study was to evaluate the effect of heel height on the knee joint direction in Genu recurvatum patients compared to normal state. The test was performed on a patient with Genu recurvatum and a healthy person with similar and match biomechanical conditions. Subjects were tested under six different positions of shoes with heels 0, 1, 2, 3, 4 and 5 cm after marking during the gate. The results of the spatial temporal geometry obtained from Vicon Motion System (six-camera T10 model, Oxford Metrics Ltd., Oxford, UK), and were used to compute and analyze the kinematic results. In this study, we tried to determine the effect of shoe heel intervention on knee joint direction correction. The results indicate that the 1 cm heel has been optimized and significantly improved in knee joint flexion and flexion-extension angle so that the difference in knee flexion-extension angle between the patient and the healthy person at some stages of walking has reached zero (good posture). The 3 cm heel compared with the 0 cm heel has reduced the knee recurvatum index (KRI) by up to 21.74% in the patient (from 219.233 mm to 47.6714 mm). According to the findings of this study, it can be concluded that heel increase is effective in correcting knee joints in Genu recurvatum and the optimum heel height is 1 cm.

Keywords: joint alignment of knee, gait analysis, genu recurvatum, heel lift, kinematics, motion-analysis

Procedia PDF Downloads 105
954 Correlation Study between Clinical and Radiological Findings in Knee Osteoarthritis

Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad

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Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.

Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis

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953 The Effect of Blood Flow Restriction on the Knee Rehabilitation

Authors: O. Casasayas, M. Vigo, R. Navarro, P. Ragazzi, P. Alvarez, A. Perez-Bellmunt

Abstract:

Introduction: The blood flow restriction training (BFR) is a method of muscle training that allows increasing the stress of muscle tissue to enhance the muscle cross-section and strength. This type of training has clear benefits in the rehabilitation field since it can improve muscle strength using low mechanical loads. The aim of this study is to know in which knee pathologies BFR has been used, what methodology was used and what were the obtained results. Study design: We performed a systematic literature search using strategies for the concepts of “blood flow restriction OR blood flow restriction training AND knee” in Medline. Articles were screened by authors and included if they used the blood flow restriction training in pathology of the knee. Results: The pathology more frequently treated by BFR was knee osteoarthritis and the variables most analyzed were strength and pain. The vascular occlusion used was 80% in the major part of studies. The groups of BFR obtained an increase of strength with less pain but not always the results are statistically significant. The evidence levels are poor in the high number of studies because in some cases there is not a control group or the evaluators were not blinded. Conclusion: The use of BFR is useful to improve muscle strength in knee pathology since it does not increase the pain, but more studies are needed to see (comprehend) if this type of treatment obtains better results than a conventional therapy. No studies have been found that compare the different occlusion effects in both the strength improvement and the pain reduction. Neither studies that analyse the effects of BFR on the muscle contractile parameters have been found.

Keywords: blood flow restriction training, knee, arthroscopy knee, physical therapy

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952 Comparison of the Proprioception Sense and Standing Balance in Patients with Osteoarthritis Before and After Total Knee Arthroplasty Surgery

Authors: S. Daneshi, G. Shahcheraghi, F. Ghaffarinejad

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Back ground: Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people around the world during the aging process. Knee joint proprioception sense decrease with OA and Total Knee Arthroplasty (TKA) surgery may affect them. We investigated two parameters of proprioception sense (the joint position sense and kinesthesia) and standing balance in affected limbs before and after TKA, in patient with Knee OA. Methods and Materials: In this Analytic study, 10 patients who were candidate for TKA during two months in Dena Hospital of Shiraz, selected for further analysis. All of cases were female in range of 55-70 years old. Participants assessed before and two weeks after TKA using three instruments: electrogoniometer and continuous passive motion (CPM) to assess Knee joint position sense and kinesthesia in 20 and 45 degrees; and chronometer to assess duration of standing balance on affected leg with open and closed eyes. Results: To examine differences between before and after of TKA scorings Willcoxon Signed Rank and Mann-Whitney was performed which indicated no significant differences between knee joint position sense and kinesthesia in 20 and 45 degrees (P>0.05) and no significant differences between Standing Balance in a patient with knee OA before and after TKA (P>0.05). Conclusion: The study indicates that, OA can affect proprioception sense and standing balance but TKA doesn’t have any effect on these parameters. Intra articular structures such as cruciate ligaments and mines are responsible for proprioception sense in normal knee joint. Since in severe knee OA the number of mechanoreceptors in these intra articular structures decrease and their function reduce more than normal knee joint, so the anterior cruciate ligaments (ACL) become defected, thus after TKA surgery which this ligament is removed no significant change was found in proprioception sense. As a result of involving proprioception sense, muscles strength and the function of vestibular system in balance, standing balance did not show significant difference before and after TKA.

Keywords: knee joint, proprioception sense, standing balance, rehabilitation sciences

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951 Morphometric Study of Human Anterior and Posterior Meniscofemoral Ligaments of the Knee Joint on Thiel Embalmed Cadavers

Authors: Mohammad Alobaidy, David Nicoll, Tracey Wilkinson

Abstract:

Background: Many patients suffer postoperative knee stability after total knee arthroplasty (joint replacement) involving posterior cruciate ligament (PCL) sacrificing or retaining, but is not clear whether the meniscofemoral ligaments (MFLs) are retained during these procedures; their function in terms of knee stability is not well established in the literature. Purpose: Macroscopic, detailed, morphometric investigation of the anterior and posterior MFLs of the knee joint was undertaken to assist understanding of knee stability after total knee arthroplasty and ligament reconstruction. Methods: Dissection of eighty Thiel embalmed knees from 19 male and 21 female cadavers was conducted, mean age 77 (range 47-99 years). The origin and insertion of the anterior and posterior MFLs were measured using high accuracy, calibrated, digital Vernier calipers at 0.01mm. Results: The means were: anterior meniscofemoral ligament (aMFL) length 28.4 ± 2.7mm; posterior meniscofemoral ligament (pMFL) length 29 ± 3.7mm; aMFL femoral width 6.4 ± 1.7mm, mid-distance ligament width 4 ± 1.1mm, meniscal ligament width 3.9 ± 1.2mm; pMFL femoral width 5.6 ± 1.5mm, mid-distance ligament width 4.1 ± 1.1mm, meniscal ligament width 4.1 ± 1.3mm. Some of the male measurements were larger than female, with significant differences in the length of the aMFL femoral length p<0.01 and pMFL femoral length p<0.007, and width of the pMFL mid-distance p<0.04. Conclusion: This study may help explore the role of the meniscofemoral ligaments in knee stability after total knee arthroplasty with a posterior cruciate ligament retaining prosthesis. Anatomical information for Thiel embalmed knees may aid orthopaedic surgeons in ligament reconstruction.

Keywords: anterior and posterior meniscofemoral ligaments, morphometric analysis, Thiel embalmed knees, knee arthroplasty

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950 Socio-Demographic and Clinical Characteristics and Use of Herbal Medicine among Patients Seeking Consultation for Knee Osteoarthritis at Secondary Healthcare Facilities in Oman

Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi

Abstract:

Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.

Keywords: knee joint, osteoarthritis, herbal medicine, Oman

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949 The Effect of Low Power Laser on CK and Some of Markers Delayed Onset Muscle Soreness (DOMS)

Authors: Bahareh Yazdanparast Chaharmahali

Abstract:

The study showed effect of low power laser therapy on knee range of motion (flexion and extension), resting angle of knee joint, knee circumference and rating of delayed onset muscle soreness induced pain, 24 and 48 hours after eccentric training of knee flexor muscle (hamstring muscle). We investigate the effects of pulsed ultrasound on swelling, relaxed, flexion and extension knee angle and pain. 20 volunteers among girl students of college voluntary participated in this research. After eccentric training, subjects were randomly divided into two groups, control and laser therapy. In day 1 and in order to induce delayed onset muscle soreness, subjects eccentrically trained their knee flexor muscles. In day 2, subjects were randomly divided into two groups: control and low power laser therapy. 24 and 48 hours after eccentric training. Variables (knee flexion and extension, srang of motion, resting knee joint angle and knee circumferences) were measured and analyzed. Data are reported as means ± standard error (SE) and repeated measured was used to assess differences within groups. Methods of treatment (low power laser therapy) have significant effects on delayed onset muscle soreness markers. 24 and 48 hours after training a significant difference was observed between mean pains of 2 groups. This difference was significant between low power laser therapy and C groups. The Bonferroni post hock is significant. Low power laser therapy trophy as used in this study did significantly diminish the effects of delayed – onset muscle soreness on swelling, relaxed – knee extension and flexion angle.

Keywords: creatine kinase, DOMS, eccentric training, low power laser

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948 Study of Biomechanical Model for Smart Sensor Based Prosthetic Socket Design System

Authors: Wei Xu, Abdo S. Haidar, Jianxin Gao

Abstract:

Prosthetic socket is a component that connects the residual limb of an amputee with an artificial prosthesis. It is widely recognized as the most critical component that determines the comfort of a patient when wearing the prosthesis in his/her daily activities. Through the socket, the body weight and its associated dynamic load are distributed and transmitted to the prosthesis during walking, running or climbing. In order to achieve a good-fit socket for an individual amputee, it is essential to obtain the biomechanical properties of the residual limb. In current clinical practices, this is achieved by a touch-and-feel approach which is highly subjective. Although there have been significant advancements in prosthetic technologies such as microprocessor controlled knee and ankle joints in the last decade, the progress in designing a comfortable socket has been rather limited. This means that the current process of socket design is still very time-consuming, and highly dependent on the expertise of the prosthetist. Supported by the state-of-the-art sensor technologies and numerical simulations, a new socket design system is being developed to help prosthetists achieve rapid design of comfortable sockets for above knee amputees. This paper reports the research work related to establishing biomechanical models for socket design. Through numerical simulation using finite element method, comprehensive relationships between pressure on residual limb and socket geometry were established. This allowed local topological adjustment for the socket so as to optimize the pressure distributions across the residual limb. When the full body weight of a patient is exerted on the residual limb, high pressures and shear forces between the residual limb and the socket occur. During numerical simulations, various hyperplastic models, namely Ogden, Yeoh and Mooney-Rivlin, were used, and their effectiveness in representing the biomechanical properties of soft tissues of the residual limb was evaluated. This also involved reverse engineering, which resulted in an optimal representative model under compression test. To validate the simulation results, a range of silicone models were fabricated. They were tested by an indentation device which yielded the force-displacement relationships. Comparisons of results obtained from FEA simulations and experimental tests showed that the Ogden model did not fit well the soft tissue material indentation data, while the Yeoh model gave the best representation of the soft tissue mechanical behavior under indentation. Compared with hyperplastic model, the result showed that elastic model also had significant errors. In addition, normal and shear stress distributions on the surface of the soft tissue model were obtained. The effect of friction in compression testing and the influence of soft tissue stiffness and testing boundary conditions were also analyzed. All these have contributed to the overall goal of designing a good-fit socket for individual above knee amputees.

Keywords: above knee amputee, finite element simulation, hyperplastic model, prosthetic socket

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947 Comparative Study Between Continuous Versus Pulsed Ultrasound in Knee Osteoarthritis

Authors: Karim Mohamed Fawzy Ghuiba, Alaa Aldeen Abd Al Hakeem Balbaa, Shams Elbaz

Abstract:

Objectives: To compare between the effects continuous and pulsed ultrasound on pain and function in patient with knee osteoarthritis. Design: Randomized-Single blinded Study. Participants: 6 patients with knee osteoarthritis with mean age 53.66±3.61years, Altman Grade II or III. Interventions: Subjects were randomly assigned into two groups; Group A received continuous ultrasound and Group B received pulsed ultrasound. Outcome measures: Effects of pulsed and continuous ultrasound were evaluated by pain threshold assessed by visual analogue scale (VAS) scores and function assessed by the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores. Results: There was no significant decrease in VAS and WOMAC scores in patients treated with pulsed or continuous ultrasound; and there were no significant differences between both groups. Conclusion: there is no difference between the effects of pulsed and continuous ultrasound in pain relief or functional outcome in patients with knee osteoarthritis.

Keywords: knee osteoarthritis, pulsed ultrasound, ultrasound therapy, continuous ultrasound

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946 Comparison of Isokinetic Powers (Flexion and Knee Extension) of Basketball and Football Players (Age 17–20)

Authors: Ugur Senturk, Ibrahım Erdemır, Faruk Guven, Cuma Ece

Abstract:

The objective of this study is to compare flexion and extension movements in knee-joint group by measuring isokinetic knee power of amateur basketball and football players. For this purpose, total 21 players were included, which consist of football players (n=12) and basketball players (n=9), within the age range of 17–20. After receiving the age, length, body weight, vertical jump, and BMI measurements of all subjects, the measurement of lower extremity knee-joint movement (Flexion-Extension) was made with isokinetic dynamometer (isomed 2000) at 60 o/sec. and 240 o/sec. angular velocity. After arrangement and grouping of collected information forms and knee flexion and extension parameters, all data were analyzed with SPSS for Windows. Descriptive analyses of the parameters were made. Non-parametric t test and Mann-Whitney U test were used to compare the parameters of football players and basketball players and to find the inter-group differences. The comparisons and relations in the range p<0.05 and p<0.01 between the groups were surveyed. As a conclusion, no statistical differences were found between isokinetic knee flexion and extension parameters of football and basketball players. However, it was found that the football players were older than the basketball players. In addition to this, the average values of the basketball players in the highest torque and the highest torque average curve were found higher than football players in comparisons of left knee extension. However, it was found that fat levels of the basketball players were found to be higher than the football players.

Keywords: isokinetic contraction, isokinetic dynamometer, peak torque, flexion, extension, football, basketball

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945 Ultrasonography of Low Extremities Veins Before and After Replacement of Knee Joint by Endoprosthesis

Authors: A. V. Alabut, V. D. Sikilinda, N. J. Nelasov, O. L. Eroshenko, M. N. Morgunov, I. V. Koroleva

Abstract:

We have analyzed the results of treatment of 204 patients with knee prosthetic arthroplasty. For the purpose of active delineation of vascular pathology triplex sonography of arterial and venous vessels of low extremities was performed in all cases in the preoperative period. When it was necessary, reconstructive vascular surgery was implemented to improve peripheral circulation and reduce the hazard of thrombosis after knee replacement. The combination of specific and nonspecific methods of thromboprophylaxis was used in perioperative period. On 7-10 day and 2.5-3 month after prosthetic arthroplasty, all patients iteratively underwent triple sonography. In case of detection of floating thrombus, urgent venous ligation was performed. Active diagnostics of venous thrombosis gave the opportunity to avoid fatal pulmonary embolism.

Keywords: knee replacement, venous thrombosis, pulmonary embolism, vascular surgery

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944 Seismic Behaviour of RC Knee Joints in Closing and Opening Actions

Authors: S. Mogili, J. S. Kuang, N. Zhang

Abstract:

Knee joints, the beam column connections found at the roof level of a moment resisting frame buildings, are inherently different from conventional interior and exterior beam column connections in the way that forces from adjoining members are transferred into joint and then resisted by the joint. A knee connection has two distinct load resisting mechanisms, each for closing and opening actions acting simultaneously under reversed cyclic loading. In spite of many distinct differences in the behaviour of shear resistance in knee joints, there are no special design provisions in the major design codes available across the world due to lack of in-depth research on the knee connections. To understand the relative importance of opening and closing actions in design, it is imperative to study knee joints under varying shear stresses, especially at higher opening-to-closing shear stress ratios. Three knee joint specimens, under different input shear stresses, were designed to produce a varying ratio of input opening to closing shear stresses. The design was carried out in such a way that the ratio of flexural strength of beams with consideration of axial forces in opening to closing actions are maintained at 0.5, 0.7, and 1.0, thereby resulting in the required variation of opening to closing joint shear stress ratios among the specimens. The behaviour of these specimens was then carefully studied in terms of closing and opening capacities, hysteretic behaviour, and envelope curves to understand the differences in joint performance based on which an attempt to suggest design guidelines for knee joints is made emphasizing the relative importance of opening and closing actions. Specimens with relatively higher opening stresses were observed to be more vulnerable under the action of seismic loading.

Keywords: Knee-joints, large-scale testing, opening and closing shear stresses, seismic performance

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943 Foot Recognition Using Deep Learning for Knee Rehabilitation

Authors: Rakkrit Duangsoithong, Jermphiphut Jaruenpunyasak, Alba Garcia

Abstract:

The use of foot recognition can be applied in many medical fields such as the gait pattern analysis and the knee exercises of patients in rehabilitation. Generally, a camera-based foot recognition system is intended to capture a patient image in a controlled room and background to recognize the foot in the limited views. However, this system can be inconvenient to monitor the knee exercises at home. In order to overcome these problems, this paper proposes to use the deep learning method using Convolutional Neural Networks (CNNs) for foot recognition. The results are compared with the traditional classification method using LBP and HOG features with kNN and SVM classifiers. According to the results, deep learning method provides better accuracy but with higher complexity to recognize the foot images from online databases than the traditional classification method.

Keywords: foot recognition, deep learning, knee rehabilitation, convolutional neural network

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942 Soft Power: Concept and Role in Country Policy

Authors: Talip Turkmen

Abstract:

From the moment the first beats, the first step into the world mankind finds him in a struggle to survive. Most important case to win this fight is power. Power is one of the most common concepts which we encounter in our life. Mainly power is ability to reach desired results on someone else or ability to penetrate into the behavior of others. Throughout history merging technology and changing political trade-offs caused the change of concept of power. Receiving a state of multipolar new world order in the 21st century and increasing impacts of media have narrowed the limits of military power. With increasing globalization and peaceful diplomacy this gap, left by military power, has filled by soft power which has ability to persuade and attract. As concepts of power soft power also has not compromised yet. For that reason it is important to specify, sources of soft power, soft power strategies and limits of soft power. The purpose of this study was to analyze concept of soft power and importance of soft power in foreign relations. This project focuses on power, hard power and soft power relations, sources of soft power and strategies to gain soft power. Datas in this project was acquired from other studies on soft power and foreign relations. This paper was prepared in terms of concept and research techniques. As a result of data gained in this study the one of important topics in international relations is balance between soft power.

Keywords: soft power, foreign policy, national power, hard power

Procedia PDF Downloads 336
941 Development of an Auxetic Tissue Implant

Authors: Sukhwinder K. Bhullar, M. B. G. Jun

Abstract:

The developments in biomedical industry have demanded the development of biocompatible, high performance materials to meet higher engineering specifications. The general requirements of such materials are to provide a combination of high stiffness and strength with significant weight savings, resistance to corrosion, chemical resistance, low maintenance, and reduced costs. Auxetic materials which come under the category of smart materials offer huge potential through measured enhancements in mechanical properties. Unique deformation mechanism, providing cushioning on indentation, automatically adjustable with its strength and thickness in response to forces and having memory returns to its neutral state on dissipation of stresses make them good candidate in biomedical industry. As simple extension and compression of tissues is of fundamental importance in biomechanics, therefore, to study the elastic behaviour of auxetic soft tissues implant is targeted in this paper. Therefore development and characterization of auxetic soft tissue implant is studied in this paper. This represents a real life configuration where soft tissue such as meniscus in knee replacement, ligaments and tendons often are taken as transversely isotropic. Further, as composition of alternating polydisperse blocks of soft and stiff segments combined with excellent biocompatibility make polyurethanes one of the most promising synthetic biomaterials. Hence selecting auxetic polyurathylene foam functional characterization is performed and compared with conventional polyurathylene foam.

Keywords: auxetic materials, deformation mechanism, enhanced mechanical properties, soft tissues

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940 Quantification of Soft Tissue Artefacts Using Motion Capture Data and Ultrasound Depth Measurements

Authors: Azadeh Rouhandeh, Chris Joslin, Zhen Qu, Yuu Ono

Abstract:

The centre of rotation of the hip joint is needed for an accurate simulation of the joint performance in many applications such as pre-operative planning simulation, human gait analysis, and hip joint disorders. In human movement analysis, the hip joint center can be estimated using a functional method based on the relative motion of the femur to pelvis measured using reflective markers attached to the skin surface. The principal source of errors in estimation of hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone. One of the main objectives in human movement analysis is the assessment of soft tissue artefact as the accuracy of functional methods depends upon it. Various studies have described the movement of soft tissue artefact invasively, such as intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess the displacements of the markers relative to the underlying bone using optical motion capture data and tissue thickness from ultrasound measurements during flexion, extension, and abduction (all with knee extended) of the hip joint. Results show that the artefact skin marker displacements are non-linear and larger in areas closer to the hip joint. Also marker displacements are dependent on the movement type and relatively larger in abduction movement. The quantification of soft tissue artefacts can be used as a basis for a correction procedure for hip joint kinematics.

Keywords: hip joint center, motion capture, soft tissue artefact, ultrasound depth measurement

Procedia PDF Downloads 209