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- The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool. [JOURNAL ARTICLE]
- J Vis Exp 2014; (88)
Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the Multiple Sclerosis Performance Test (MSPT), which represents a new approach to quantifying MS related disability. The MSPT takes advantage of advances in computer technology, information technology, biomechanics, and clinical measurement science. The resulting MSPT represents a computer-based platform for precise, valid measurement of MS severity. Based on, but extending the Multiple Sclerosis Functional Composite (MSFC), the MSPT provides precise, quantitative data on walking speed, balance, manual dexterity, visual function, and cognitive processing speed. The MSPT was tested by 51 MS patients and 49 healthy controls (HC). MSPT scores were highly reproducible, correlated strongly with technician-administered test scores, discriminated MS from HC and severe from mild MS, and correlated with patient reported outcomes. Measures of reliability, sensitivity, and clinical meaning for MSPT scores were favorable compared with technician-based testing. The MSPT is a potentially transformative approach for collecting MS disability outcome data for patient care and research. Because the testing is computer-based, test performance can be analyzed in traditional or novel ways and data can be directly entered into research or clinical databases. The MSPT could be widely disseminated to clinicians in practice settings who are not connected to clinical trial performance sites or who are practicing in rural settings, drastically improving access to clinical trials for clinicians and patients. The MSPT could be adapted to out of clinic settings, like the patient's home, thereby providing more meaningful real world data. The MSPT represents a new paradigm for neuroperformance testing. This method could have the same transformative effect on clinical care and research in MS as standardized computer-adapted testing has had in the education field, with clear potential to accelerate progress in clinical care and research.
- VO2 Kinetics and Metabolic Contributions Whilst Swimming at 95, 100, and 105% of the Velocity at VO2 max. [Journal Article]
- Biomed Res Int 2014.:675363.
A bioenergetical analysis of swimming at intensities near competitive distances is inexistent. It was aimed to compare the transient VO2 kinetics responses and metabolic contributions whilst swimming at different velocities around VO2max. 12 trained male swimmers performed (i) an incremental protocol to determine the velocity at VO2max (vVO2max) and (ii) three square wave exercises from rest to 95, 100, and 105% of vVO2max. VO2 was directly measured using a telemetric portable gas analyser and its kinetics analysed through a double-exponential model. Metabolic contributions were assessed through the sum of three energy components. No differences were observed in the fast component response (τ 1-15, 18, and 16 s, A 1-36, 34, and 37 mL · kg(-1) · min(-1), and Gain-32, 29, and 30 mL · min(-1) at 95, 100, and 105% of the vVO2max, resp.) but A2 was higher in 95 and 100% compared to 105% intensity (480.76 ± 247.01, 452.18 ± 217.04, and 147.04 ± 60.40 mL · min(-1), resp.). The aerobic energy contribution increased with the time sustained (83 ± 5, 74 ± 6, and 59 ± 7% for 95, 100, and 105%, resp.). The adjustment of the cardiovascular and/or pulmonary systems that determine O2 delivery and diffusion to the exercising muscles did not change with changing intensity, with the exception of VO2 slow component kinetics metabolic profiles.
- Hematological and biochemical markers of iron status in a male, young, physically active population. [Journal Article]
- Biomed Res Int 2014.:349182.
The aim of this study was to establish reference intervals (RIs) for the hemogram and iron status biomarkers in a physically active population. The study population included male volunteers (n = 150) with an average age of 19 ± 1 years who had participated in a regular and controlled exercise program for four months. Blood samples were collected to determine hematological parameters using a Sysmex XE-5000 analyzer (Sysmex, Kobe, Japan). Iron, total iron-binding capacity (TIBC), transferrin saturation and ferritin, and high-sensitivity C-reactive protein (CRP) concentrations in serum samples were measured using commercial kits (Roche Diagnostics, GmbH, Mannheim, Germany) and a Roche/Hitachi 902 analyzer. The RIs were established using the RefVal program 4.1b. The leucocyte count, TIBC, and CRP and ferritin concentrations exhibited higher RIs compared with those in a nonphysically active population. Thirty volunteers (outliers) were removed from the reference population due to blood abnormalities. Among the outliers, 46% exhibited higher CRP concentrations and lower concentrations of iron and reticulocyte hemoglobin compared with the nonphysically active population (P < 0.001). Our results showed that it is important to establish RIs for certain laboratory parameters in a physically active population, especially for tests related to the inflammatory response and iron metabolism.
- The biomechanical effects of stapes replacement by prostheses on the tympano-ossicular chain. [JOURNAL ARTICLE]
- Int J Numer Method Biomed Eng 2014 Jul 14.
Hearing is a sequence of processes in which the ear translates sound waves into electrical signals, which are then sent to the brain where they are interpreted as sound. The ossicular chain of the middle ear is formed by three ossicles (malleus, incus and stapes), of which the last and smallest, the stapes, vibrates, thus communicating with the inner ear through the stapes footplate. When abnormal bone formation immobilizes the stapes (otosclerosis) the passage of sound does not correctly occur and hearing can be compromised. In most cases, surgery is an option for its treatment. The stapes is totally or partially replaced by a prosthesis (stapedectomy or stapedotomy respectively) allowing the passage of sound to the inner ear. This work presents a study on the behavior of different stapes prostheses, considering their biomechanical characteristics. The stapes was replaced by different prostheses, made of dissimilar materials: stainless steel, teflon and titanium. The umbo and stapes footplate displacements for the models with these prostheses were obtained and compared with the displacements obtained with the model representative of the normal ear. In the models with prostheses, the displacements are found in the hole where the prosthesis is attached. This article is protected by copyright. All rights reserved.
- The Effects of Age on the Morphometry of the Cervical Spinal Cord and Spinal Column in Adult Rats: An MRI-Based Study. [JOURNAL ARTICLE]
- Anat Rec (Hoboken) 2014 Jul 18.
Rat models are commonly used to investigate the pathophysiological pathways and treatment outcomes after spinal cord injury (SCI). The high incidence of fall-induced SCI in older adults has created a need for aging models of SCI in rats to investigate potential age-related differences in SCI severity and outcomes. The aims of this study were to determine the influences of age and vertebral level on the geometries of the cervical spinal cord and spinal column in a rat model. Three young (3 months) and three aged (12 months) Fischer 344 rats were imaged in a high field (7 T) small-animal magnetic resonance imaging system. All spinal cord geometry variables (including depth, width, and axial cross-sectional area) and one spinal canal variable (depth) were significantly larger in the aged specimens by an average of 8.1%. There were main effects of vertebral level on all spinal cord variables and four spinal canal variables with values generally larger at C4 as compared to C6 (average increases ranged from 5.7% to 12.9% in spinal cord measures and 5.4% to 6.8% in spinal canal measures). High inter-rater reliability between two measurers was observed with a mean intraclass correlation of 0.921 and percent difference of 0.9% across all variables measured. This study clearly demonstrates that cervical spinal cord geometry changes between the ages of 3 and 12 months in Fischer 344 rats. This information can aid in the planning and interpretation of studies that use a rat model to investigate the influence of age on cervical SCI. Anat Rec, 2014. © 2014 Wiley Periodicals, Inc.
- Biomechanics and functional distortion of the human mandible. [JOURNAL ARTICLE]
- J Investig Clin Dent 2014 Jul 17.
The reaction to the use of finite element analysis (FEA) in the study of the human body has been particularly enthusiastic. Of equal and challenging complexity is the investigation of load/stress distribution and morphological distortion of the human mandible under functional loads. Furthermore, the mandible also impacts directly on body function and esthetics, playing a vital role, such as mastication and speech. The application of FEA to the biomechanical investigation of the oral systems, such as human teeth and mandibular bone remodeling, began in the early 1970s. The clinical significance of jaw deformation is unknown. The primary concern is that deformation might result in an ill-fitting superstructure or the creation of harmful strains in the patient-implant complex. Although mandibular implant treatment has a high success rate, the possibility of failure caused by these dimensional changes and the related micromotion cannot be ignored.
- Evaluation of proximal joint kinematics and muscle strength following ACL reconstruction surgery in female athletes. [JOURNAL ARTICLE]
- J Orthop Res 2014 Jul 8.
Despite the intense focus on outcomes following an anterior cruciate ligament (ACL) reconstruction, it is not yet known whether unresolved abnormal hip and trunk neuromuscular control exists. The purpose of this study was to compare trunk and hip kinematics during running, hip abductor and external rotator strength, and trunk control between females who had undergone an ACL reconstruction and healthy control participants. We compared 20 ACL reconstructed females to 20 healthy individuals, measuring abduction and external rotation strength, a trunk control test, and performed an instrumented gait evaluation during running. Comparisons between groups were made for non-sagittal peak hip angles, forward trunk lean, trunk ipsilateral lean at initial contact, trunk control and hip abduction, and external rotation strength. We found no significant differences in hip abduction (p = 0.25), hip external rotation strength (p = 0.63), peak hip adduction (p = 0.11) or hip internal rotation angle (p = 0.47). The ACL group did have a significantly greater ipsilateral trunk lean (p = 0.028), forward lean (p = 0.004), and had higher errors on the trunk stability test (p = 0.007). We found significant differences in trunk control, suggesting further attention should be devoted to this component of rehabilitation. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
- Cement brand and preparation effects cement-in-cement mantle shear strength. [JOURNAL ARTICLE]
- Hip Int 2014 Jul 17.:0.
Creating bi-laminar cement mantles as part of revision hip arthroplasty is well-documented but there is a lack of data concerning the effect of cement brand on the procedure. The aim of this study was to compare the shear strength of bi-laminar cement mantles using various combinations of two leading bone cement brands.Bi-laminar cement mantles were created using Simplex P with Tobramycin, and Palacos R+G: Simplex-Simplex (SS); Simplex-Palacos (SP); Palacos-Simplex (PS); and Palacos-Palacos (PP). Additionally, specimens were produced by rasping (R) the surface of the original mantle, or leaving it unrasped (U), leading to a total of eight groups (n = 10). Specimens were loaded in shear, at 0.1 mm/min, until failure, and the maximum shear strength calculated.The highest mean shear strength was found in the PSU and PSR groups (23.69 and 23.89 MPa respectively), and the lowest in the PPU group (14.70 MPa), which was significantly lower than all but two groups. Unrasped groups generally demonstrated greater standard error than rasped groups.In a further comparison to assess the effect of the new cement mantle brand, irrespective of the brand of the original mantle, Simplex significantly increased the shear strength compared to Palacos with equivalent preparation.It is recommended that the original mantle is rasped prior to injection of new cement, and that Simplex P with Tobramycin be used in preference to Palacos R+G irrespective of the existing cement type. Further research is needed to investigate more cement brands, and understand the underlying mechanisms relating to cement-in-cement procedures.
- The contribution of proteoglycans to the mechanical behavior of mineralized tissues. [REVIEW]
- J Mech Behav Biomed Mater 2014 Jun 25.:91-104.
It has been widely shown that proteoglycans (PG) and their glycosaminoglycan (GAG) side-chains form supramolecular aggregates that interconnect the collagenous network in connective tissues and play a significant role in regulating the mechanical behavior of the extracellular matrix, particularly in soft tissues. However, collective evidence of the mechanical participation of PGs and GAGs in mineralized tissues remains poorly explored in the literature. Here, we address this knowledge gap and discuss the participation of PGs on the biomechanics of mineralized tissues including dentine, cementum and bone. We review evidence suggesting that, on a microscale, PGs regulate the hydrostatic and osmotic pressure, as well as the poroelastic behavior of dentine and bone. On the nanoscale, we review the so-called sliding filament theory and intramolecular stretching of GAGs. We also discuss recent interpretations whereby folding and unfolding of the PG protein core, potentially in association with SIBLING proteins, may be a contributing factor to the mechanical behavior of mineralized tissues. Finally, we review in vitro and in vivo studies of mineralized tissues with targeted disruption or digestion of specific PG family members, which provide further insights into their relevance to the mechanical properties of load bearing hard tissues. In summary, this review brings forth collective evidence suggesting that PGs and GAGs, although less than 5% of the tissue matrix, may play a role in the mechanical behavior and durability of mineralized tissues.
- An affine continuum mechanical model for cross-linked F-actin networks with compliant linker proteins. [JOURNAL ARTICLE]
- J Mech Behav Biomed Mater 2014 May 22.:78-90.
Cross-linked actin networks are important building blocks of the cytoskeleton. In order to gain deeper insight into the interpretation of experimental data on actin networks, adequate models are required. In this paper we introduce an affine constitutive network model for cross-linked F-actin networks based on nonlinear continuum mechanics, and specialize it in order to reproduce the experimental behavior of in vitro reconstituted model networks. The model is based on the elastic properties of single filaments embedded in an isotropic matrix such that the overall properties of the composite are described by a free-energy function. In particular, we are able to obtain the experimentally determined shear and normal stress responses of cross-linked actin networks typically observed in rheometer tests. In the present study an extensive analysis is performed by applying the proposed model network to a simple shear deformation. The single filament model is then extended by incorporating the compliance of cross-linker proteins and further extended by including viscoelasticity. All that is needed for the finite element implementation is the constitutive model for the filaments, the linkers and the matrix, and the associated elasticity tensor in either the Lagrangian or Eulerian formulation. The model facilitates parameter studies of experimental setups such as micropipette aspiration experiments and we present such studies to illustrate the efficacy of this modeling approach.