Search results for: soft knee
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1190

Search results for: soft knee

1040 Numerical Investigation of Soft Clayey Soil Improved by Soil-Cement Columns under Harmonic Load

Authors: R. Ziaie Moayed, E. Ghanbari Alamouty

Abstract:

Deep soil mixing is one of the improvement methods in geotechnical engineering which is widely used in soft soils. This article investigates the consolidation behavior of a soft clay soil which is improved by soil-cement column (SCC) by numerical modeling using Plaxis2D program. This behavior is simulated under vertical static and cyclic load which is applied on the soil surface. The static load problem is the simulation of a physical model test in an axisymmetric condition which uses a single SCC in the model center. The results of numerical modeling consist of settlement of soft soil composite, stress on soft soil and column, and excessive pore water pressure in the soil show a good correspondence with the test results. The response of soft soil composite to the cyclic load in vertical direction also compared with the static results. Also the effects of two variables namely the cement content used in a SCC and the area ratio (the ratio of the diameter of SCC to the diameter of composite soil model, a) is investigated. The results show that the stress on the column with the higher value of a, is lesser compared with the stress on other columns. Different rate of consolidation and excessive pore pressure distribution is observed in cyclic load problem. Also comparing the results of settlement of soil shows higher compressibility in the cyclic load problem.

Keywords: area ratio, consolidation behavior, cyclic load, numerical modeling, soil-cement column

Procedia PDF Downloads 129
1039 Behavior of Common Wheat under the Influence of Treated Waste Water

Authors: Chiahi Nadia

Abstract:

The aim of our work is to monitor the behavior of soft wheat on a morpho-physiological and agronomic scale under the influence of treated wastewater. Physico-chemical analyses of the treated sewage were also carried out, and our tests were carried out on two varieties of common wheat (Triticum aestivum L), HD1220 and ARZ. For this, a seedling was made, and two different irrigations were chosen, one using treated wastewater from the Sedrata (Wilaya of Souk ahras - Algeria) WWTP and the other stormwater as a control. The tests focused on soil and soft wheat parameters, and based on our results, the soft wheat development, physiological and yield parameters appear to respond favorably to the use of these waters.

Keywords: common wheat (Triticum aestivum L.), purified wastewater, irrigation, morph physiological and agronomic parameters

Procedia PDF Downloads 34
1038 Effect of Two Bouts of Eccentric Exercise on Knee Flexors Changes in Muscle-Tendon Lengths

Authors: Shang-Hen Wu, Yung-Chen Lin, Wei-Song Chang, Ming-Ju Lin

Abstract:

This study investigated whether the repeated bout effect (RBE) of knee flexors (KF) eccentric exercise would be changed in muscle-tendon lengths. Eight healthy university male students used their KF of non-dominant leg and performed a bout of 60 maximal isokinetic (30°/s) eccentric contractions (MaxECC1). A week after MaxECC1, all subjects used the same KF to perform a subsequent bout of MaxECC2. Changes in maximal isokinetic voluntary contraction torque (MVC-CON), muscle soreness (SOR), relaxed knee joint angle (RANG), leg circumference (CIR), and ultrasound images (UI; muscle-tendon length and muscle angle) were measured before, immediately after, 1-5 days after each bout. Two-way ANOVA was used to analyze all the dependent variables. After MaxECC1, all the dependent variables (e.g. MVC-CON: ↓30%, muscle-tendon length: ↑24%, muscle angle: ↑15%) showed significantly change. Following MaxECC2, all the above dependent variables (e.g. MVC-CON:↓21%, tendon length: ↑16%, muscle angle: ↑6%) were significantly smaller than those of MaxECC1. These results of this study found that protective effect conferred by MaxECC1 against MaxECC2, and changes in muscle damage indicators, muscle-tendon length and muscle angle following MaxECC2 were smaller than MaxECC1. Thus, the amount of shift of muscle-tendon length and muscle angle was related to the RBE.

Keywords: eccentric exercise, maximal isokinetic voluntary contraction torque, repeated bout effect, ultrasound

Procedia PDF Downloads 306
1037 Preliminary Report on the Assessment of the Impact of the Kinesiology Taping Application versus Placebo Taping on the Knee Joint Position Sense

Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

Abstract:

Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

Procedia PDF Downloads 300
1036 Field Tests and Numerical Simulation of Tunis Soft Soil Improvement Using Prefabricated Vertical Drains

Authors: Marwa Ben Khalifa, Zeineb Ben Salem, Wissem Frikha

Abstract:

This paper presents a case study of “Radès la Goulette” bridge project using the technique of prefabricated vertical drains (PVD) associated with step by step construction of preloading embankments with averaged height of about 6 m. These embankments are founded on a highly compressible layer of Tunis soft soil. The construction steps included extensive soil instrumentation such as piezometers and settlement plates for monitoring the dissipation of excess pore water pressures and settlement during the consolidation of Tunis soft soil. An axisymmetric numerical model using the 2D finite difference code FLAC was developed and calibrated using laboratory tests to predict the soil behavior and consolidation settlements. The constitutive model impact for simulating the soft soil behavior is investigated. The results of analyses show that numerical analysis provided satisfactory predictions for the field performance during the construction of Radès la Goulette embankment. The obtained results show the effectiveness of PVD in the acceleration of the consolidation time. A comparison of numerical results with theoretical analysis was presented.

Keywords: tunis soft soil, radès bridge project, prefabricated vertical drains, FLAC, acceleration of consolidation

Procedia PDF Downloads 98
1035 Self-Inflating Soft Tissue Expander Outcome for Alveolar Ridge Augmentation a Randomized Controlled Clinical and Histological Study

Authors: Alaa T. Ali, Nevine H. Kheir El Din, Ehab S. Abdelhamid, Ahmed E. Amr

Abstract:

Objective: Severe alveolar bone resorption is usually associated with a deficient amount of soft tissues. soft tissue expansion is introduced to provide an adequate amount of soft tissue over the grafted area. This study aimed to assess the efficacy of sub-periosteal self-inflating osmotic tissue expanders used as preparatory surgery before horizontal alveolar ridge augmentation using autogenous onlay block bone graft. Methods: A prospective randomized controlled clinical trial was performed. Sixteen partially edentulous patients demanding horizontal bone augmentation in the anterior maxilla were randomly assigned to horizontal ridge augmentation with autogenous bone block grafts harvested from the mandibular symphysis. For the test group, soft tissue expanders were placed sub-periosteally before horizontal ridge augmentation. Impressions were taken before and after STE, and the cast models were optically scanned and superimposed to be used for volumetric analysis. Horizontal ridge augmentation was carried out after STE completion. For the control group, a periosteal releasing incision was performed during bone augmentation procedures. Implants were placed in both groups at re-entry surgery after six months period. A core biopsy was taken. Histomorphometric assessment for newly formed bone surface area, mature collagen area fraction, the osteoblasts count, and blood vessel count were performed. The change in alveolar ridge width was evaluated through bone caliper and CBCT. Results: Soft tissue expander successfully provides a Surplus amount of soft tissues in 5 out of 8 patients in the test group. Complications during the expansion period were perforation through oral mucosa occurred in two patients. Infection occurred in one patient. The mean soft tissue volume gain was 393.9 ± 322mm. After 6 months. The mean horizontal bone gains for the test and control groups were 3.14 mm and 3.69 mm, respectively. Conclusion: STE with a sub-periosteal approach is an applicable method to achieve an additional soft tissue and to reduce bone block graft exposure and wound dehiscence.

Keywords: soft tissue expander, ridge augmentation, block graft, symphysis bone block

Procedia PDF Downloads 93
1034 A Stochastic Model to Predict Earthquake Ground Motion Duration Recorded in Soft Soils Based on Nonlinear Regression

Authors: Issam Aouari, Abdelmalek Abdelhamid

Abstract:

For seismologists, the characterization of seismic demand should include the amplitude and duration of strong shaking in the system. The duration of ground shaking is one of the key parameters in earthquake resistant design of structures. This paper proposes a nonlinear statistical model to estimate earthquake ground motion duration in soft soils using multiple seismicity indicators. Three definitions of ground motion duration proposed by literature have been applied. With a comparative study, we select the most significant definition to use for predict the duration. A stochastic model is presented for the McCann and Shah Method using nonlinear regression analysis based on a data set for moment magnitude, source to site distance and site conditions. The data set applied is taken from PEER strong motion databank and contains shallow earthquakes from different regions in the world; America, Turkey, London, China, Italy, Chili, Mexico...etc. Main emphasis is placed on soft site condition. The predictive relationship has been developed based on 600 records and three input indicators. Results have been compared with others published models. It has been found that the proposed model can predict earthquake ground motion duration in soft soils for different regions and sites conditions.

Keywords: duration, earthquake, prediction, regression, soft soil

Procedia PDF Downloads 116
1033 Effectiveness of Impairment Specified Muscle Strengthening Programme in a Group of Disabled Athletes

Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

Abstract:

Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

Procedia PDF Downloads 322
1032 Vision Aided INS for Soft Landing

Authors: R. Sri Karthi Krishna, A. Saravana Kumar, Kesava Brahmaji, V. S. Vinoj

Abstract:

The lunar surface may contain rough and non-uniform terrain with dips and peaks. Soft-landing is a method of landing the lander on the lunar surface without any damage to the vehicle. This project focuses on finding a safe landing site for the vehicle by developing a method for the lateral velocity determination of the lunar lander. This is done by processing the real time images obtained by means of an on-board vision sensor. The hazard avoidance phase of the soft-landing starts when the vehicle is about 200 m above the lunar surface. Here, the lander has a very low velocity of about 10 cm/s:vertical and 5 m/s:horizontal. On the detection of a hazard the lander is navigated by controlling the vertical and lateral velocity. In order to find an appropriate landing site and to accordingly navigate, the lander image processing is performed continuously. The images are taken continuously until the landing site is determined, and the lander safely lands on the lunar surface. By integrating this vision-based navigation with the INS a better accuracy for the soft-landing of the lunar lander can be obtained.

Keywords: vision aided INS, image processing, lateral velocity estimation, materials engineering

Procedia PDF Downloads 433
1031 Permissible Horizontal Displacements during the Construction of Vertical Shafts in Soft Soils at the Valley of Mexico: Case History

Authors: Joel M. De La Rosa R.

Abstract:

In this paper, the results obtained when monitoring the horizontal deformations of the soil mass are detailed, during each of the construction stages of several vertical shafts located in the soft soils of the Valley of Mexico, by means of the flotation method. From the analysis of these results, the magnitude and percentage relationship with respect to the diameter and depth of excavation of the horizontal deformations that occurred during the monitoring period is established. Based on the horizontal deformation monitoring system and the information provided by the supervisor's site log, the construction stages that have the greatest impact on deformations are established. Additionally, an analysis of the deformations is carried out, which takes into account the resistance and deformability characteristics of the excavated soils, as well as the prevailing hydraulic conditions. This work will allow construction engineers and institutions in charge of infrastructure works in the Valley of Mexico to establish permissible ranges for horizontal deformations that can occur in very soft and saturated soils, during the different construction stages; improving response protocols to potentially dangerous behaviors.

Keywords: vertical shaft, flotation method, very soft clays, construction supervision

Procedia PDF Downloads 154
1030 Effects of the Slope Embankment Variation on Influence Areas That Causes the Differential Settlement around of Embankment

Authors: Safitri W. Nur, Prathisto Panuntun L. Unggul, M. Ivan Adi Perdana, R. Dary Wira Mahadika

Abstract:

On soft soil areas, high embankment as a preloading needed to improve the bearing capacity of the soil. For sustainable development, the construction of embankment must not disturb the area around of them. So, the influence area must be known before the contractor applied their embankment design. For several cases in Indonesia, the area around of embankment construction is housing resident and other building. So that, the influence area must be identified to avoid the differential settlement occurs on the buildings around of them. Differential settlement causes the building crack. Each building has a limited tolerance for the differential settlement. For concrete buildings, the tolerance is 0,002 – 0,003 m and for steel buildings, the tolerance is 0,006 – 0,008 m. If the differential settlement stands on the range of that value, building crack can be avoided. In fact, the settlement around of embankment is assumed as zero. Because of that, so many problems happen when high embankment applied on soft soil area. This research used the superposition method combined with plaxis analysis to know the influences area around of embankment in some location with the differential characteristic of the soft soil. The undisturbed soil samples take on 55 locations with undisturbed soil samples at some soft soils location in Indonesia. Based on this research, it was concluded that the effects of embankment variation are if more gentle the slope, the influence area will be greater and vice versa. The largest of the influence area with h initial embankment equal to 2 - 6 m with slopes 1:1, 1:2, 1:3, 1:4, 1:5, 1:6, 1:7, 1:8 is 32 m from the edge of the embankment.

Keywords: differential settlement, embankment, influence area, slope, soft soil

Procedia PDF Downloads 376
1029 Interrelationship between Quadriceps' Activation and Inhibition as a Function of Knee-Joint Angle and Muscle Length: A Torque and Electro and Mechanomyographic Investigation

Authors: Ronald Croce, Timothy Quinn, John Miller

Abstract:

Incomplete activation, or activation failure, of motor units during maximal voluntary contractions is often referred to as muscle inhibition (MI), and is defined as the inability of the central nervous system to maximally drive a muscle during a voluntary contraction. The purpose of the present study was to assess the interrelationship amongst peak torque (PT), muscle inhibition (MI; incomplete activation of motor units), and voluntary muscle activation (VMA) of the quadriceps’ muscle group as a function of knee angle and muscle length during maximal voluntary isometric contractions (MVICs). Nine young adult males (mean + standard deviation: age: 21.58 + 1.30 years; height: 180.07 + 4.99 cm; weight: 89.07 + 7.55 kg) performed MVICs in random order with the knee at 15, 55, and 95° flexion. MI was assessed using the interpolated twitch technique and was estimated by the amount of additional knee extensor PT evoked by the superimposed twitch during MVICs. Voluntary muscle activation was estimated by root mean square amplitude electromyography (EMGrms) and mechanomyography (MMGrms) of agonist (vastus medialis [VM], vastus lateralis [VL], and rectus femoris [RF]) and antagonist (biceps femoris ([BF]) muscles during MVICs. Data were analyzed using separate repeated measures analysis of variance. Results revealed a strong dependency of quadriceps’ PT (p < 0.001), MI (p < 0.001) and MA (p < 0.01) on knee joint position: PT was smallest at the most shortened muscle position (15°) and greatest at mid-position (55°); MI and MA were smallest at the most shortened muscle position (15°) and greatest at the most lengthened position (95°), with the RF showing the greatest change in MA. It is hypothesized that the ability to more fully activate the quadriceps at short compared to longer muscle lengths (96% contracted at 15°; 91% at 55°; 90% at 95°) might partly compensate for the unfavorable force-length mechanics at the more extended position and consequent declines in VMA (decreases in EMGrms and MMGrms muscle amplitude during MVICs) and force production (PT = 111-Nm at 15°, 217-NM at 55°, 199-Nm at 95°). Biceps femoris EMG and MMG data showed no statistical differences (p = 0.11 and 0.12, respectively) at joint angles tested, although there were greater values at the extended position. Increased BF muscle amplitude at this position could be a mechanism by which anterior shear and tibial rotation induced by high quadriceps’ activity are countered. Measuring and understanding the degree to which one sees MI and VMA in the QF muscle has particular clinical relevance because different knee-joint disorders, such ligament injuries or osteoarthritis, increase levels of MI observed and markedly reduced the capability of full VMA.

Keywords: electromyography, interpolated twitch technique, mechanomyography, muscle activation, muscle inhibition

Procedia PDF Downloads 307
1028 Evaluation of Prehabilitation Prior to Surgery for an Orthopaedic Pathway

Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

Abstract:

Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

Procedia PDF Downloads 165
1027 Long-Term Follow-Up of Dynamic Balance, Pain and Functional Performance in Cruciate Retaining, Posterior Stabilized Total Knee Arthroplasty

Authors: Ahmed R. Z. Baghdadi,  Mona H. Gamal Eldein

Abstract:

Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel unsatisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for group I, II, and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed-Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months post-operatively in group I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months post-operatively in group I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: dynamic balance, functional performance, knee arthroplasty, long-term

Procedia PDF Downloads 376
1026 Differential Effect of Technique Majors on Isokinetic Strength in Youth Judoka Athletes

Authors: Chungyu Chen, Yi-Cheng Chen, Po-Hsian Hsu, Hsin-Ying Chen, Yen-Po Hsiao

Abstract:

The purpose of this study was to assess the muscular strength performance of upper and lower extremity in isokinetic system for the youth judo players, and also to compare the strength difference between major techniques. Sixteen male and 20 female judo players (age: 16.7 ± 1.6 years old, training age: 4.5 ± 0.8 years) were served as the volunteers for this study. There were 21 players major hand techniques and 15 players major foot techniques. The Biodex S4 Pro was used to assess the strength performance of extensor and flexor of concentric action under the load condition of 30 degree/sec, 60 degree/sec, and 120 degree/sec for elbow joints and knee joints. The strength parameters were included the maximal torque, the normalized maximal torque, the average power, and the average maximal torque. A t test for independent groups was used to evaluate whether hand major and foot major differ significantly with an alpha level of .05. The result showed the maximal torque of left knee extensor in foot major players (243.5 ± 36.3 Nm) was higher significantly than hand major (210.7 ± 21.0 Nm) under the load of 30 degree/sec (p < .05). There were no differences in upper extremity strength between the hand and foot techniques major in three loads (ps < .05). It indicated that the judo player is required to develop the upper extremity strength overall to secure the execution of major techniques.

Keywords: knee, elbow, power, judo

Procedia PDF Downloads 418
1025 Visco-Hyperelastic Finite Element Analysis for Diagnosis of Knee Joint Injury Caused by Meniscal Tearing

Authors: Eiji Nakamachi, Tsuyoshi Eguchi, Sayo Yamamoto, Yusuke Morita, H. Sakamoto

Abstract:

In this study, we aim to reveal the relationship between the meniscal tearing and the articular cartilage injury of knee joint by using the dynamic explicit finite element (FE) method. Meniscal injuries reduce its functional ability and consequently increase the load on the articular cartilage of knee joint. In order to prevent the induction of osteoarthritis (OA) caused by meniscal injuries, many medical treatment techniques, such as artificial meniscus replacement and meniscal regeneration, have been developed. However, it is reported that these treatments are not the comprehensive methods. In order to reveal the fundamental mechanism of OA induction, the mechanical characterization of meniscus under the condition of normal and injured states is carried out by using FE analyses. At first, a FE model of the human knee joint in the case of normal state – ‘intact’ - was constructed by using the magnetron resonance (MR) tomography images and the image construction code, Materialize Mimics. Next, two types of meniscal injury models with the radial tears of medial and lateral menisci were constructed. In FE analyses, the linear elastic constitutive law was adopted for the femur and tibia bones, the visco-hyperelastic constitutive law for the articular cartilage, and the visco-anisotropic hyperelastic constitutive law for the meniscus, respectively. Material properties of articular cartilage and meniscus were identified using the stress-strain curves obtained by our compressive and the tensile tests. The numerical results under the normal walking condition revealed how and where the maximum compressive stress occurred on the articular cartilage. The maximum compressive stress and its occurrence point were varied in the intact and two meniscal tear models. These compressive stress values can be used to establish the threshold value to cause the pathological change for the diagnosis. In this study, FE analyses of knee joint were carried out to reveal the influence of meniscal injuries on the cartilage injury. The following conclusions are obtained. 1. 3D FE model, which consists femur, tibia, articular cartilage and meniscus was constructed based on MR images of human knee joint. The image processing code, Materialize Mimics was used by using the tetrahedral FE elements. 2. Visco-anisotropic hyperelastic constitutive equation was formulated by adopting the generalized Kelvin model. The material properties of meniscus and articular cartilage were determined by curve fitting with experimental results. 3. Stresses on the articular cartilage and menisci were obtained in cases of the intact and two radial tears of medial and lateral menisci. Through comparison with the case of intact knee joint, two tear models show almost same stress value and higher value than the intact one. It was shown that both meniscal tears induce the stress localization in both medial and lateral regions. It is confirmed that our newly developed FE analysis code has a potential to be a new diagnostic system to evaluate the meniscal damage on the articular cartilage through the mechanical functional assessment.

Keywords: finite element analysis, hyperelastic constitutive law, knee joint injury, meniscal tear, stress concentration

Procedia PDF Downloads 206
1024 A 5-V to 30-V Current-Mode Boost Converter with Integrated Current Sensor and Power-on Protection

Authors: Jun Yu, Yat-Hei Lam, Boris Grinberg, Kevin Chai Tshun Chuan

Abstract:

This paper presents a 5-V to 30-V current-mode boost converter for powering the drive circuit of a micro-electro-mechanical sensor. The design of a transconductance amplifier and an integrated current sensing circuit are presented. In addition, essential building blocks for power-on protection such as a soft-start and clamp block and supply and clock ready block are discussed in details. The chip is fabricated in a 0.18-μm CMOS process. Measurement results show that the soft-start and clamp block can effectively limit the inrush current during startup and protect the boost converter from startup failure.

Keywords: boost converter, current sensing, power-on protection, step-up converter, soft-start

Procedia PDF Downloads 982
1023 The Role of Movement Quality after Osgood-Schlatter Disease in an Amateur Football Player: A Case Study

Authors: D. Pogliana, A. Maso, N. Milani, D. Panzin, S. Rivaroli, J. Konin

Abstract:

This case aims to identify the role of movement quality during the final stage of return to sport (RTS) in a male amateur football player 13 years old after passing the acute phase of the bilateral Osgood-Schlatter disease (OSD). The patient, after a year from passing the acute phase of OSD with the abstention of physical activity, reports bilateral anterior knee pain at the beginning of the football sport activity. Interventions: After the orthopedist check, who recommended physiotherapy sessions for the correction of motor patterns and the isometric reinforcement of the muscles of the quadriceps, the rehabilitation intervention was developed in 7 weeks through 14 sessions of neuro-motor training (NMT) with a frequency of two weekly sessions and six sessions of muscle-strengthening with a frequency of one weekly session. The sessions of NMT were carried out through free body exercises (or with overloads) with visual bio-feedback with the help of two cameras (one with anterior vision and one with lateral vision of the subject) and a big touch screen. The aim of these sessions of NMT was to modify the dysfunctional motor patterns evaluated by the 2D motion analysis test. The test was carried out at the beginning and at the end of the rehabilitation course and included five movements: single-leg squat (SLS), drop jump (DJ), single-leg hop (SLH), lateral shuffle (LS), and change of direction (COD). Each of these movements was evaluated through the video analysis of dynamic valgus knee, pelvic tilt, trunk control, shock absorption, and motor strategy. A free image analysis software (Kinovea) was then used to calculate scores. Results: Baseline assessment of the subject showed a total score of 59% on the right limb and 64% on the left limb (considering an optimal score above 85%) with large deficits in shock absorption capabilities, the presence of dynamic valgus knee, and dysfunctional motor strategies defined “quadriceps dominant.” After six weeks of training, the subject achieved a total score of 80% on the right limb and 86% on the left limb, with significant improvements in shock absorption capabilities, the presence of dynamic knee valgus, and the employment of more hip-oriented motor strategies on both lower limbs. The improvements shown in dynamic knee valgus, greater hip-oriented motor strategies, and improved shock absorption identified through six weeks of the NMT program can help a teenager amateur football player to manage the anterior knee pain during sports activity. In conclusion, NMT was a good choice to help a 13 years old male amateur football player to return to performance without pain after OSD and can also be used with all this type of athletes of the other teams' sports.

Keywords: movement analysis, neuro-motor training, knee pain, movement strategies

Procedia PDF Downloads 94
1022 The Effectiveness of Extracorporeal Shockwave Therapy on Pain and Motor Function in Subjects with Knee Osteoarthritis A Systematic Review and Meta-Analysis of Randomized Clinical Trial

Authors: Vu Hoang Thu Huong

Abstract:

Background and Purpose: The effects of Extracorporeal Shockwave Therapy (ESWT) in the participants with knee osteoarthritis (KOA) were unclear on physical performance although its effects on pain had been investiagted. This study aims to explore the effects of ESWT on pain relief and physical performance on KOA. Methods: The studies with the randomized controlled design to investigate the effects of ESWT on KOA were systematically searched using inclusion and exclusion criteria through seven electronic databases including Pubmed etc. between 1990 and Dec 2022. To summarize those data, visual analog scale (VAS) or pain scores were determined for measure of pain intensity. Range of knee motion, or the scores of physical activities including Lequesne index (LI), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were determined for measure of physical performances. The first evaluate after treatment period was define as the effect of post-treatment period or immediately effect; and the last evaluate was defined as the effect of following period or the end effect in our study. Data analysis was performed using RevMan 5.4.1 software. A significant level was set at p<0.05. Results: Eight studies (number of participant= 499) reporting the ESWT effects on mild-to-moderate severity (Grades I to III Kellgren–Lawrence) of KOA were qualified for meta-analysis. Compared with sham or placebo group, the ESWT group had a significant decrease of VAS rest score (0.90[0.12~1.67] as mean difference [95% confidence interval]) and pain score WOMAC (2.49[1.22~3.76]), and a significant improvement of physical performance with a decrease of the scores of WOMAC activities (8.18[3.97~12.39]), LI (3.47[1.68~5.26]), and KOOS (5.87[1.73~ 10.00]) in the post-treatment period. There were also a significant decrease of WOMAC pain score (2.83[2.12~3.53]) and a significant decrease of the scores of WOMAC activities (9.47[7.65~11.28]) and LI (4.12[2.34 to 5.89]) in the following period. Besides, compared with other treatment groups, ESWT also displayed the improvement in pain and physical performance, but it is not significant. Conclusions: The ESWT was effective and valuable method in pain relief as well as in improving physical activities in the participants with mild-to-moderate KOA. Clinical Relevance: There are the effects of ESWT on pain relief and the improvement of physical performance in the with KOA.

Keywords: knee osteoarthritis, extracorporeal shockwave therapy, pain relief, physical performance, shockwave

Procedia PDF Downloads 49
1021 Employees and Their Perception of Soft Skills on Their Employability

Authors: Sukrita Mukherjee, Anindita Chaudhuri

Abstract:

Soft skills are a crucial aspect for employees, and these skills are not confined to any particular field rather, it guarantees further career growth and job opportunities for employees who are seeking growth. Soft skills are also regarded as personality-specific skills that are observable and are qualitative in nature, which determines an employee’s strengths as a leader. When an employee intends to hold his job, then the person must make effective use of his personal resources, that, in turn, impacts his employability in a positive manner. An employee at his workplace is expected to make effective use of his personal resources. The resources that are to be used by the employee are generally of two types. First type of resources are occupation related, which is related with the educational background of the employee, and the second type of resources are the psychological resources of the employee, such as self-knowledge, career orientation awareness, sense of purpose and emotional literacy, that are considered crucial for an employee in his workplace. The present study is a qualitative study which includes 10 individuals working in IT Sector and Service Industry, respectively. For IT sector, graduate people are considered, and for the Service Industry, individuals who have done a Professional course in order to get into the industry are considered. The emerging themes from the findings after thematic analysis reveal that different aspect of Soft skills such as communication, decision making, constant learning, keeping oneself updated with the latest technological advancement, emotional intelligence are some of the important factors that helps an employee not only to sustain his job, but also grow in his workplace.

Keywords: employabiliy, soft skils, employees, resources, workplace

Procedia PDF Downloads 32
1020 Influence Zone of Strip Footing on Untreated and Cement Treated Sand Mat Underlain by Soft Clay (2nd reviewed)

Authors: Sharifullah Ahmed

Abstract:

Shallow foundation on soft soils without ground improvement can represent a high level of settlement. In such a case, an alternative to pile foundations may be shallow strip footings placed on a soil system in which the upper layer is untreated or cement-treated compacted sand to limit the settlement within a permissible level. This research work deals with a rigid plane-strain strip footing of 2.5m width placed on a soil consisting of untreated or cement treated sand layer underlain by homogeneous soft clay. Both the thin and thick compared the footing width was considered. The soft inorganic cohesive NC clay layer is considered undrained for plastic loading stages and drained in consolidation stages, and the sand layer is drained in all loading stages. FEM analysis was done using PLAXIS 2D Version 8.0 with a model consisting of clay deposits of 15m thickness and 18m width. The soft clay layer was modeled using the Hardening Soil Model, Soft Soil Model, Soft Soil Creep model, and the upper improvement layer was modeled using only the Hardening Soil Model. The system is considered fully saturated. The value of natural void ratio 1.2 is used. Total displacement fields of strip footing and subsoil layers in the case of Untreated and Cement treated Sand as Upper layer are presented. For Hi/B =0.6 or above, the distribution of major deformation within an upper layer and the influence zone of footing is limited in an upper layer which indicates the complete effectiveness of the upper layer in bearing the foundation effectively in case of the untreated upper layer. For Hi/B =0.3 or above, the distribution of major deformation occurred within an upper layer, and the function of footing is limited in the upper layer. This indicates the complete effectiveness of the cement-treated upper layer. Brittle behavior of cemented sand and fracture or cracks is not considered in this analysis.

Keywords: displacement, ground improvement, influence depth, PLAXIS 2D, primary and secondary settlement, sand mat, soft clay

Procedia PDF Downloads 63
1019 Development of Soft-Core System for Heart Rate and Oxygen Saturation

Authors: Caje F. Pinto, Jivan S. Parab, Gourish M. Naik

Abstract:

This paper is about the development of non-invasive heart rate and oxygen saturation in human blood using Altera NIOS II soft-core processor system. In today's world, monitoring oxygen saturation and heart rate is very important in hospitals to keep track of low oxygen levels in blood. We have designed an Embedded System On Peripheral Chip (SOPC) reconfigurable system by interfacing two LED’s of different wavelengths (660 nm/940 nm) with a single photo-detector to measure the absorptions of hemoglobin species at different wavelengths. The implementation of the interface with Finger Probe and Liquid Crystal Display (LCD) was carried out using NIOS II soft-core system running on Altera NANO DE0 board having target as Cyclone IVE. This designed system is used to monitor oxygen saturation in blood and heart rate for different test subjects. The designed NIOS II processor based non-invasive heart rate and oxygen saturation was verified with another Operon Pulse oximeter for 50 measurements on 10 different subjects. It was found that the readings taken were very close to the Operon Pulse oximeter.

Keywords: heart rate, NIOS II, oxygen saturation, photoplethysmography, soft-core, SOPC

Procedia PDF Downloads 166
1018 Role of Leadership in Project Management

Authors: Miriam Filipová, Peter Balco

Abstract:

At present, in Slovak and Czech Republic, the education within the field of Project Management is carried out either within the higher education or via commercial entities, whilst the most used contents are the commonly used methodologies of project management. Obtaining a diploma after completing a university degree or a training certificate does not automatically mean the success of the project or the success of the project manager. The importance of leadership and soft skills in project management is either not included at all within the training of project managers, or it is only partially reflected. From the methodology perspective, the most important things during the preparation and management of the projects are preparation of the project plan, resource planning, and project realization in accordance with the chosen methodology. However, the key element on which the success of the project depends on are the people – whether they are team members on the supplier's side, the stakeholders, or the end users. This research focuses on the real needs of working project managers, on the development of their strengths, expertise, skills, and knowledge regarding leadership and soft skills. At the same time, it looks into identifying the elements that they consider to be key to the success of the projects they have managed and successfully delivered. The result of this research is the input for creating recommendations for a comprehensive education of project managers in the field of leadership and soft skills.

Keywords: project management, leadership, soft skills, education, academic degree, certificates, skills, talents, knowledge

Procedia PDF Downloads 127
1017 Soft Robotic System for Mechanical Stimulation of Scaffolds During Dynamic Cell Culture

Authors: Johanna Perdomo, Riki Lamont, Edmund Pickering, Naomi C. Paxton, Maria A. Woodruff

Abstract:

Background: Tissue Engineering (TE) has combined advanced materials, such as biomaterials, to create affordable scaffolds and dynamic systems to generate stimulation of seeded cells on these scaffolds, improving and maintaining the cellular growth process in a cell culture. However, Few TE skin products have been clinically translated, and more research is required to produce highly biomimetic skin substitutes that mimic the native elasticity of skin in a controlled manner. Therefore, this work will be focused on the fabrication of a novel mechanical system to enhance the TE treatment approaches for the reparation of damaged tissue skin. Aims: To archive this, a soft robotic device will be created to emulate different deformation of skin stress. The design of this soft robot will allow the attachment of scaffolds, which will then be mechanically actuated. This will provide a novel and highly adaptable platform for dynamic cell culture. Methods: Novel, low-cost soft robot is fabricated via 3D printed moulds and silicone. A low cost, electro-mechanical device was constructed to actuate the soft robot through the controlled combination of positive and negative air pressure to control the different state of movements. Mechanical tests were conducted to assess the performance and calibration of each electronic component. Similarly, pressure-displacement test was performed on scaffolds, which were attached to the soft robot, applying various mechanical loading regimes. Lastly, digital image correlation test was performed to obtain strain distributions over the soft robot’s surface. Results: The control system can control and stabilise positive pressure changes for long hours. Similarly, pressure-displacement test demonstrated that scaffolds with 5µm of diameter and wavy geometry can displace at 100%, applying a maximum pressure of 1.5 PSI. Lastly, during the inflation state, the displacement of silicone was measured using DIC method, and this showed a parameter of 4.78 mm and strain of 0.0652. Discussion And Conclusion: The developed soft robot system provides a novel and low-cost platform for the dynamic actuation of tissue scaffolds with a target towards dynamic cell culture.

Keywords: soft robot, tissue engineering, mechanical stimulation, dynamic cell culture, bioreactor

Procedia PDF Downloads 64
1016 Low Dose In-Line Electron Holography for 3D Atomic Resolution Tomography of Soft Materials

Authors: F. R. Chen, C. Kisielowski, D. Van Dyck

Abstract:

In principle, the latest generation aberration-corrected transmission electron microscopes (TEMs) could achieve sub-Å resolution, but there is bottleneck that hinders the final step towards revealing 3D structure. Firstly, in order to achieve a resolution around 1 Å with single atom sensitivity, the electron dose rate needs to be sufficiently large (10⁴-10⁵eÅ⁻² s⁻¹). With such large dose rate, the electron beam can induce surfaces alterations or even bulk modifications, in particular, for electron beam sensitive (soft) materials such as nm size particles, organic materials, proteins or macro-molecules. We will demonstrate methodology of low dose electron holography for observing 3D structure for soft materials such as single Oleic acid molecules at atomic resolution. The main improvement of this new type of electron holography is based on two concepts. Firstly, the total electron dose is distributed over many images obtained at different defocus values from which the electron hologram is then reconstructed. Secondly, in contrast to the current tomographic methods that require projections from several directions, the 3D structural information of the nano-object is then extracted from this one hologram obtained from only one viewing direction.

Keywords: low dose electron microscopy, in-line electron holography, atomic resolution tomography, soft materials

Procedia PDF Downloads 159
1015 Classification System for Soft Tissue Injuries of Face: Bringing Objectiveness to Injury Severity

Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

Abstract:

Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

Procedia PDF Downloads 356
1014 Design, Modelling, and Fabrication of Bioinspired Frog Robot for Synchronous and Asynchronous Swimming

Authors: Afaque Manzoor Soomro, Faheem Ahmed, Fida Hussain Memon, Kyung Hyun Choi

Abstract:

This paper proposes the bioinspired soft frog robot. All printing technology was used for the fabrication of the robot. Polyjet printing was used to print the front and back limbs, while ultrathin filament was used to print the body of the robot, which makes it a complete soft swimming robot. The dual thrust generation approach has been proposed by embedding the main muscle and antagonistic muscle in all the limbs, which enables it to attain high speed (18 mm/s), and significant control of swimming in dual modes (synchronous and asynchronous modes). To achieve the swimming motion of the frog, the design, motivated by the rigorous modelling and real frog dynamics analysis, enabled the as-developed frog robot (FROBOT) to swim at a significant level of consistency with the real frog. The FROBOT (weighing 65 g) can swim at different controllable frequencies (0.5–2Hz) and can turn in any direction by following custom-made LabVIEW software’s commands which enables it to swim at speed up to 18 mm/s on the surface of deep water (100 cm) with excellent weight balance.

Keywords: soft robotics, soft actuator, frog robot, 3D printing

Procedia PDF Downloads 76
1013 Operating Characteristics of Point-of-Care Ultrasound in Identifying Skin and Soft Tissue Abscesses in the Emergency Department

Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

Abstract:

Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

Procedia PDF Downloads 335
1012 A New Approach for PE100 Characterization; An in-Reactor HDPE Alloy with Semi Hard and Soft Segments

Authors: Sasan Talebnezhad, Parviz Hamidia

Abstract:

GPC and RMS analysis showed no distinct difference between PE 100 On, Off, and Reference grade. But FTIR spectra and multiple endothermic peaks obtained from SSA analysis, attributed to heterogeneity of ethylene sequence length, lamellar thickness and also the non-uniformity of short chain branching, showed sharp discrepancy and proposed a blend structure of high-density polyethylenes in PE 100 grade. Catalysis along with process parameters dictates poly blend PE 100 structure. This in-reactor blend is a mixture of compatible co-crystallized phases with different crystalinity, forming a physical semi hard and soft segment network responsible for improved impact properties in PE 100 pipe grade. We propose a new approach for PE100 evaluation that is more efficient than normal microstructure characterization.

Keywords: HDPE, pipe grade, in-reactor blend, hard and soft segments

Procedia PDF Downloads 421
1011 Ipsilateral Heterotopic Ossification in the Knee and Shoulder Post Long COVID-19

Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

Abstract:

A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

Procedia PDF Downloads 45