Bone changes composition and structure to adapt to its mechanical environment. Osteocytes are putative mechanosensors responsible for orchestrating the bone remodeling process. Recent in vitro studies showed that osteocytes could sense and respond to substrate strain and fluid shear. However the capacity of osteocytes to sense cyclic hydraulic pressure (CHP) associated with physiological mechanical loading is not well understood. In this study, osteocyte-like MLO-Y4 cells were subjected to CHP of 68 kPa at 0.5 Hz, and the effects of CHP on intracellular calcium concentration, cytoskeleton organization, mRNA expression of genes related to bone remodeling, and osteocyte apoptosis were investigated. The results indicate that osteocytes could sense CHP and respond by increased intracellular calcium concentration, altered microtubule organization, an increase in COX-2 mRNA level and RANKL/OPG mRNA ratio, and decreased apoptosis. Therefore cyclic hydraulic pressure in bone a mechanical stimulus to osteocytes and may play a role in regulating bone remodeling.

Job rotation is recommended to prevent musculoskeletal disorders (MSD). The premise is by involving different tissues a “working rest” for other tissues is created. The possible health benefits from this relief have not been investigated with regards to different grips in hand intensive jobs. The purpose of this study is to investigate hand intensive tasks and determine whether rotating between the power grip and lateral pinch grip can provide a benefit. A psychophysical load adjustment protocol was used. To investigate the effect of rotation, three different trials were collected. These included: power grip only, lateral pinch only, and alternating the two grips. Each trial was 60 minutes in duration, with a 12second cycle time, and 25% duty cycle. Fourteen subjects were recruited and pre-screened for any upper extremity disorders. Subjects were instructed to “work as hard as you can without straining your hand, wrist or forearm”; by adjusting their resistance settings to achieve a maximum acceptable force (MAF). Grip forces were exerted on an adjustable system using a hand grip dynamometer. Ratings of perceived discomfort were reported every 10minutes. Electromyography (EMG) was collected on eight forearm muscles during the combination trial. The demand for both lateral pinch and power grip tasks were at self selected levels and no fatigue was reported within MAF, EMG recordings, and discomfort reports. The rotation between lateral pinch and power grip had no apparent effect on MAF. However, EMG data hinted that there was a rotation of activation between first dorsal interossei and the forearm flexors (not statistically significant). Less discomfort was reported within the combination trial than the single grip (not significant). The study found no measurable difference in MAF when rotating between the power grip and lateral pinch. Considering there was no increase in demand, there is potential benefit to rotation, with trends to rotating activation between muscles, less discomfort being reported, and a general preference for the rotation. Given the high rates of MSD, and rotation being an effective tool to lower exposure, further investigations are required to understand relationships between similar muscles groups within hand intensive work environments.

In a world of war and turmoil in developing nations, land mines are becoming a concern, as millions of them are scattered in countries all over the world. Moreover, land mine prevention programs cannot clear land mine fields as fast as they are detonated each day. As a result, there are thousands that fall victim each year. There is immense demand for newer technologies to replace the aging prostheses used in these war torn nations. The active prosthetic knee (APK) design project is a novel design that utilizes simple, robust one degree of freedom (DOF) mechanics, while providing fully active knee torque control. The APK utilizes a high-speed brushed servomotor, providing the necessary torque and dynamics to provide the necessary gait characteristics of human locomotion. The main research contributions of this thesis are: 1) the mechanics and 2) the intelligence of the APK. This thesis investigates and highlights the prosthetic’s design process. The human biological system is studied and used as the design criteria when designing the device. Anthropometric data was used to determine the sizing and other physical properties. Moreover, Adaptive-Network-based Fuzzy-Interference Systems (ANFIS) and Fuzzy Interference Systems (FIS) are used to provide control to the APK. Finite element analysis (FEA) verifies the structural integrity of the APK. Four simulations are analyzed: equivalent stress, equivalent strain, shear stress and total deformation. These four simulations provide a mathematical interpretation of the physical system. We found that the first prototype, although a sound design, can be further improved to allow greater loading capabilities. Moreover, cyclical loading and total life cycles would also be significantly improved. A modular test stand is also designed and prototyped to allow APK testing. Since the APK prototype cannot be immediately placed on a human test subject, the test stand allows for experimentation in replicating human gait cycles.

Purpose: Biomechanical differences between people with low back pain (LBP) and healthy controls have been shown previously. LBP has been associated with standing postures in occupational settings. A transient pain-generating model allows for comparisons between pain developers (PD) and non-pain developers (NPD). The first objective was to utilize a multifactorial approach to characterize differences between PD and NPD individuals. The second objective was to investigate the impact of exercise on LBP during standing. Methods: Forty-three participants without any history of LBP volunteered for this study. Participants performed pre- and post-standing functional movements and 2-hours of standing. Continuous electromyography (EMG) data were collected from 16 trunk and hip muscles, kinematic and kinetic data were used to construct an 8-segment rigid link model. Vertebral joint rotation stiffness (VJRS) measures were calculated. Participants completed visual analog scales (VAS) rating LBP every 15 minutes during the 2-hr standing. Participants were classified as PD or NPD based on greater than 10 mm increase in VAS. Participants were assigned to exercise (EX) or control (CON) groups. All participants returned for a second data collection following 4-weeks. Results: Forty percent of participants developed LBP during standing. The PD group had elevated muscle co-activation prior to reports of pain (p < 0.05). Following standing, there was a decrease in VJRS about the lateral bend axis during unilateral stance. PDEX had decreased VAS scores during the second data collection (p = 0.007) compared with PDCON. Male PDEX had decreased gluteus medius co-activation during standing (p < 0.05). Between-day repeatability for the CON groups was excellent with intraclass correlation coefficients > 0.80 for the majority of the outcome measures. Conclusions: There were clear differences between PD/NPD groups in muscle activation patterns, prior to subjective reports of LBP, supporting the hypothesis that some of the differences observed between these groups may be predisposing rather than adaptive. An exercise intervention resulted in positive changes in the PD group, both in subjective pain scores as well as muscle activation profiles. Elevated muscle co-activation in the first 15-30 minutes of standing may indicate that an individual is at increased risk for LBP during standing.

Low back pain is highly prevalent in the developed world, with 80% of the population being affected at some point in their lives. Herniation, a common injury to the intervertebral disc, is characterized as the posterior migration of the nucleus pulposus through the layers of the annulus fibrosus. Various risk factors have been associated with the development of disc herniation, but the mechanisms are largely not understood. For example, exposure to vibration has been linked to the occurrence of herniation, yet our understanding of this association is not clear. It is hypothesized that vibration cyclically loads the tissues of the intervertebral disc until failure occurs as a result of fatigue. Tissues at risk of fatigue failure may include the intra-lamellar matrix, the connective tissue found between collagen fibres within a single lamella, and the inter-lamellar matrix, the connective tissue found between adjacent lamellae. In order to determine the mechanistic link between vibration and herniation, a firm understanding of the properties of the intervertebral disc as well as the intra and inter-lamellar matrices are of utmost importance. Further, it is important to determine these properties under physiological loading scenarios. This thesis consists of five studies, which have each provided a unique piece to the intervertebral disc herniation puzzle in order to better understand this mechanistic link. First, it was discovered that annular tissue is subject to significantly higher stresses and is stiffer under biaxial strain as compared to uniaxial strain. Biaxial strain is more representative of the in vivo loading scenario and provides more accurate information regarding scenarios that the annulus can tolerate and those that can result in injury. It was also revealed that, when strained at physiological strain rates (up to 4%/sec), these mechanical properties do not change such that they are independent of strain rate. Therefore, when strained at varying rates akin to voluntary movement, the annulus is not subject to higher stresses or altered stiffness. Second, the effect of vibration, an acknowledged risk factor for herniation, was examined on the mechanical properties of the intra and inter-lamellar matrices. It was discovered that vibration altered these matrices such that they were more extensible and strained to greater magnitudes, yet did not reach higher stresses before failing. It was hypothesized that this increased extensibility was due to damage to elastin, as elastin assists in minimizing tissue deformation and helps tissues recover from tensile strain. The final study assessed the effect of exposure to vibration on the development of disc herniation. The initiation of herniation was observed in a significantly greater number of intervertebral discs exposed to vibration as compared to a control condition. Although epidemiological studies had documented a correlation between exposure to vibration and herniation, this was the first study to conclude that exposure to vibration is in fact a mechanical risk factor for the development of herniation and increases the incidence of herniation. Further, based on the findings of the mechanical properties of the intra and inter-lamellar matrices, and in particular the observed 15-20 times greater failure strength of the intra as compared to inter-lamellar matrix, it would appear that the inter-lamellar matrix, and thus delamination, may be the weakest link in the herniation pathway. This thesis has uncovered new information regarding physiological mechanical properties of the annulus. Further, new information regarding the intra and inter-lamellar matrices was obtained, improving our understanding of the healthy disc. Last, by subjecting the disc to a known risk factor for herniation, hypotheses were generated regarding the initiation and progression of disc herniation, specifically related to the roles of the intra and inter-lamellar matrices.

General body discomfort increases over time during prolonged sitting and it is typically accepted that no single posture can be comfortably maintained for long periods. Despite this knowledge, workplace exposure to prolonged sitting is very common. Sedentary occupations that expose workers to prolonged sitting are associated with an increased risk of developing low back pain (LBP), disc degeneration and lumbar disc herniation. Given the prevalence of occupations with a large amount of seated work and the propensity for a dose-response relationship between sitting and LBP, refining our understanding of the biomechanics of the lumbar spine during sitting is important. Sitting imposes a flexed posture that, when held for a prolonged period of time, may cause detrimental effects on the tissues of the spine. While sitting is typically viewed as a sedentary and constrained task, several researchers have identified the importance of investigating movement during prolonged sitting. The studies in this thesis were designed to address the following two global questions: (1) How do the lumbar spine and pelvis move during sitting? (2) Can lumbar spine movement and postures explain LBP and injury associated with prolonged sitting? The first study (Study 1) examined static X-ray images of the lower lumbo-sacral spine in a range of standing and seated postures to measure the intervertebral joint angles that contribute to spine flexion. The main finding was that the lower lumbo-sacral joints approach their total range of motion in seated postures. This suggests that there could be increased loading of the passive tissues surrounding the lower lumbo-sacral intervertebral joints, contributing to low back pain and/or injury from prolonged sitting. Study 2 compared external spine angles measured using accelerometers from L3 to the sacrum with corresponding angles measured from X-ray images. While the external and internal angles did not match, the accelerometers were sensitive to changes in seated lumbar posture and were consistent with measurements made using similar technology in other studies. This study also provided an in-depth analysis of the current methods for data treatment and how these methods affect the outcomes. A further study (Study 3) employed videofluoroscopy to investigate the dynamic rotational kinematics of the intervertebral joints of the lumbo-sacral spine in a seated slouching motion in order to determine a sequence of vertebral motion. The pelvis did not initiate the slouching motion and a disordered sequence of vertebral rotation was observed at the initiation of the movement. Individuals performed the slouching movement using a number of different motion strategies that influenced the IVJ angles attained during the slouching motion. From the results of Study 1, it would appear as though the lowest lumbar intervertebral joint (L5/S1) contribute the most to lumbo-sacral flexion in upright sitting, as it is at approximately 60% of its end range in this posture. However, the results from Study 3 suggest that there is no consistent sequence of intervertebral joint rotation when flexing the spine from upright to slouched sitting. When moving from standing to sitting, lumbar spine flexion primarily occurs at the lowest joint (i.e. L5/S1); however, a disordered sequence of vertebral motion the different motion patterns observed may indicate that different joints approach their end range before the completion of the slouching movement. In order to understand the biomechanical factors associated with sitting induced low back pain, Study 4 examined the postural responses and pain scores of low back pain sufferers compared with asymptomatic individuals during prolonged seated work. The distinguishing factor between these two groups was their respective time-varying seated lumbar spine movement patterns. Low back pain sufferers moved more than asymptomatic individuals did during 90 minutes of seated work and they reported increased low back pain over time. Frequent shifts in lumbar spine posture could be a mechanism for redistributing the load to different tissues of the spine, particularly if some tissues are more vulnerable than others. However, increased movement did not completely eliminate pain in individuals with pre-existing LBP. The LBP sufferers’ seated spine movements increased in frequency and amplitude as time passed. It is likely that these movements became more difficult to properly control because LBP patients may lack proper lumbar spine postural control. The results of this study highlight the fact that short duration investigations of seated postures do not accurately represent the biological responses to prolonged exposure. Individuals with sitting-induced low back pain and those without pain differ in how they move during seated work and this will have different impacts on the tissues of the lumbar spine. A tissue-based rational for the detrimental effects on the spinal joint of prolonged sitting was examined in Study 5 using an in vitro spine model and simulated spine motion patterns documented in vivo from Study 4. The static protocol simulated 2 hours of sitting in one posture. The shift protocol simulated infrequent but large changes in posture, similar to the seated movements observed in a group of LBP sufferers. The fidget protocol replicated small, frequent movements about one posture, demonstrated by a group of asymptomatic individuals. Regardless of the amount of spine movement around one posture, all specimens lost a substantial amount of disc height. Furthermore, the passive range of motion of a joint changed substantially after 2 hours of simulated sitting. Specifically, there were step-like regions of reduced stiffness throughout the passive range of motion particularly around the adopted “seated flexion” angle. However, small movements around a posture (i.e. fidgeting) may mitigate the changes in the passive stiffness in around the seated flexion angle. The load transferred through the joint during the 2-hour test was varied either by changing postures (i.e. shifting) or by a potential creep mechanism (i.e. maintaining one static posture). Fidgeting appeared to reduce the variation of load carriage through the joint and may lead to a more uniform increase in stiffness across the entire passive range of motion. These changes in passive joint mechanics could have greater consequences for a low back pain population who may be more susceptible to abnormal muscular control and clinical instability. Nevertheless, the observed disc height loss and changes in joint mechanics may help explain the increased risk of developing disc herniation and degeneration if exposure to sitting is cumulative over many days, months and years. In summary, this work has highlighted that seated postures place the joints of the lumbar spine towards their end range of motion, which is considered to be risky for pain/injury in a number of tissue sources. In-depth analyses of both internal and external measurements of spine postures identified different seated motion patterns and self-selected seated postures that may increase the risk for developing LBP. The model of seated LBP/discomfort development used in this thesis provided evidence that large lumbar spine movements do not reduce pain in individuals with pre-existing LBP. Tissue-based evidence demonstrated that 2 hours of sitting substantially affects IVJ mechanics and may help explain the increased risk of developing disc herniation and degeneration if exposure to sitting is cumulative over many days, months and years. The information obtained from this thesis will help develop and refine interventions in the workplace to help reduce low back pain during seated work.

Abstract: Previous lower limb weighting studies have placed a load on the legs bilaterally and tested different placement locations. It was previously determined that kinematic changes occur with greater masses and at joints proximal to weight placement [1]. Other studies have determined that these changes exist for a short adaptation period before parameters revert to a steady state [2]. Tasks that require voluntary gait modifications such as obstacle clearance have also been performed with lower leg bilateral weight addition [4]. In cases of normal obstacle clearance increased flexion at all three joints in the lower limb is needed to safely traverse the obstacle [3]. The goal of this study was to investigate joint kinematics and kinetics of unilaterally weighted participants using level ground force platform collection techniques, rather than a treadmill. It was hoped that this would allow for new insight into the adaptation periods and strategic motor pattern changes seen at the ankle, knee and hip. Kinematic and force platform data were collected on two groups of 10 healthy male subjects. Group 1 (mean age = 23years, mean weight = 82.181kg, mean height = 1.798m) was a normal walking group and group 2 (mean age = 24.8years, mean weight = 79.901kg, mean height = 1.773m) was an obstacle clearance group. Both groups participated in 20 trials each of three different conditions; normal, weighted and weight off using a 2.27kg limb mass attached just proximal to the right maleoli markers. A repeated-measures two-way ANOVA was carried out on relevant variables in order to determine statistical significance. Weight addition and removal affected the kinematics and kinetics of the normal walking and obstacle clearance groups. This effect was more prominent in the normal walking group. If changes were seen, trials 1 through 3 were the locations showing a quick adaptation followed by a leveling off back to a new steady state in later trials. Participants in the normal walking group chose to utilize the hip joint in order to control for weight addition and removal. Kinematically, changes in the hip joint angle occurred at all instances analyzed throughout the gait cycle with this effect being more prominent in the weight off condition. In conjunction with this, the hip joint energy generation increased during all phases of the gait cycle while the ankle and knee joints either decreased energy generation or increased energy absorption. In the obstacle group, participants also chose to increase flexion at the hip joint. However, the ankle joint also had either decreased plantarflexion or increased dorsiflexion at all the instances analyzed during the gait cycle. However, joint energy generation increases at these joints were only found during stance and at heel contact. The toe obstacle clearance values also showed a marked increase in trial 1 for the weighted condition which demonstrates a voluntary gait modification made by participants to safely traverse the obstacle that was quickly adapted for. Overall, the results found by previous studies using treadmill collection techniques were still seen in overground force platform data but they were not as robust. References: 1.Martin PE et al. J Biomech. 1990; 23(6):529-536. 2.Noble et al. Exp Brain Res. 2006; 169: 482-495. 3.Patla AE et al. Exp Brain Res. 1995; 196: 499-504. 4.Reid MJ et al. Neurosci Res Comm. 2001; 29(2): 79-87.

The aim of this study was to understand injury mechanisms behind fractures of the upper extremities in car accidents. Volvo Car Corporation initiated this project based on the fact that no safety system today focuses on preventing injuries to the upper extremity. A literature study was undertaken focusing on the basic anatomy of the upper extremity, different fracture types and fracture mechanisms. Three subsets, from 1998 – January 2009, were selected from Volvo’s statistical accident database: 1) all occupants involved in an accident 2) all occupants with a MAIS2+ injury 3) all occupants with an upper extremity fracture. These subsets were used in a comparison, using frequency analyses. The comparison analysis showed that frontal impact is the dominating accident type for all three subsets. The comparison analysis also indicated that the risk for upper extremity fractures follows the pattern of MAIS2+ injury risk. An in-depth study using 92 selected cases, including 80 occupants, was also performed. All available information, such as medical records, questionnaires completed by the occupants and photographs from the accident scene was collected and analysed. The analysis of the in-depth study, together with knowledge retrieved from the literature study, resulted in six different mechanism groups that were used to categorise fractures. The groups were then analysed individually in regard to accident type and fractured segment of the upper extremity. Analysis of the mechanism groups showed that frontal impact is the dominating accident type in these subsets as well. It could also be seen that the fractures occurring in the in-depth study are quite evenly distributed along the upper extremities. Upper extremity injuries are relatively infrequent in car accidents but may result in long-term disability, including chronic deformity, pain, weakness and loss of motion. More attention is therefore necessary in order to develop a safer environment for car occupants.

A major function of the central nervous system (CNS) during locomotion is the ability to maintain dynamic stability during threats to balance. The CNS uses reactive, predictive, and anticipatory mechanisms in order to accomplish this. Previously, stability has been estimated using single measures. Since the entire body works as a system, dynamic stability should be examined by integrating kinematic, kinetic, and electromyographical measures of the whole body. This thesis examines three threats to stability (recovery from a frontal plane surface translation, stepping onto and walking on a compliant surface, and obstacle clearance on a compliant surface). These threats to stability would enable a full body stability analysis for reactive, predictive, and anticipatory CNS control mechanisms. From the results in this study, observing various biomechanical variables provides a more precise evaluation of dynamic stability and how it is achieved. Observations showed that different methods of increasing stability (eg. Lowering full body COM, increasing step width) were controlled by differing CNS mechanisms during a task. This provides evidence that a single measure cannot determine dynamic stability during a locomotion task and the body must be observed entirely to determine methods used in the maintenance of dynamic stability.

Job rotation is recommended to prevent musculoskeletal disorders (MSD). The premise is by involving different tissues a “working rest” for other tissues is created. The possible health benefits from this relief have not been investigated with regards to different grips in hand intensive jobs. The purpose of this study is to investigate hand intensive tasks and determine whether rotating between the power grip and lateral pinch grip can provide a benefit. A psychophysical load adjustment protocol was used. To investigate the effect of rotation, three different trials were collected. These included: power grip only, lateral pinch only, and alternating the two grips. Each trial was 60 minutes in duration, with a 12second cycle time, and 25% duty cycle. Fourteen subjects were recruited and pre-screened for any upper extremity disorders. Subjects were instructed to “work as hard as you can without straining your hand, wrist or forearm”; by adjusting their resistance settings to achieve a maximum acceptable force (MAF). Grip forces were exerted on an adjustable system using a hand grip dynamometer. Ratings of perceived discomfort were reported every 10minutes. Electromyography (EMG) was collected on eight forearm muscles during the combination trial. The demand for both lateral pinch and power grip tasks were at self selected levels and no fatigue was reported within MAF, EMG recordings, and discomfort reports. The rotation between lateral pinch and power grip had no apparent effect on MAF. However, EMG data hinted that there was a rotation of activation between first dorsal interossei and the forearm flexors (not statistically significant). Less discomfort was reported within the combination trial than the single grip (not significant). The study found no measurable difference in MAF when rotating between the power grip and lateral pinch. Considering there was no increase in demand, there is potential benefit to rotation, with trends to rotating activation between muscles, less discomfort being reported, and a general preference for the rotation. Given the high rates of MSD, and rotation being an effective tool to lower exposure, further investigations are required to understand relationships between similar muscles groups within hand intensive work environments.