Transcatheter aortic heart valve replacement (TAVR) is a procedure to replace a failing aortic valve and is becoming the new standard of care for patients that are not candidates for open-heart surgery [2]. However, this minimally invasive technique has shown to cause ischemic brain lesions, or “silent infarcts”, in 90% of TAVR patients, which can increase the patient’s risk for stroke by two to four times in future years [3]. Claret Medical Inc., a medical device company, has developed a cerebral protection system that filters and captures embolic debris released during endovascular procedures, such as TAVR. This thesis utilized CT scans from Claret Medical to create a physical construct of the aortic arch to experimentally validate a theoretical computer model through flow visualization. The hypothesis was that the empirical model can accurately mimic the fluid dynamic properties of the aortic arch in order validate an in silico model using the finite elements program COMSOL MultiPhysics® Modeling Software. The physical model was created from a patient CT scan of the aortic arch using additive manufacturing (3D printing) and polymer casting, resulting in the shape of the aortic arch within a transparent, silicone material. Fluid was pumped through the model to visualize and quantify the velocity of the fluid within the aortic arch. COMSOL MultiPhysics® was used to model the aortic arch and obtain velocity measurements, which were statistically compared to the velocity measurements from the physical model. There was no significant difference between the values of the physical model and the computer model, confirming the hypothesis. Overall, this study successfully used CT scans to create an anatomically accurate physical model that was validated by a computer model using a novel technique of flow visualization. As TAVR and similar procedures continue to develop, the need for experimental evaluation and visualization of devices will continue to grow, making this project relevant to many companies in the medical device industry.

Osteoarthritis (OA) is a degenerative condition of articular cartilage that affects more than 25 million people in the US. Joint injuries, like anterior cruciate ligament (ACL) tears, can lead to OA due to a change in articular cartilage loading. Gait analysis combined with knee joint finite element modeling (FEM) has been used to predict the articular cartilage loading. To predict the change of articular cartilage loading during gait due to various ACL injuries, a tibiofemoral FEM was developed from magnetic resonance images (MRIs) of a 33 year male, with no prior history of knee injuries. The FEM was validated for maximum contact pressure and anterior tibial translation using cadaver knee studies. The FEM was used to model gait of knees with an intact ACL, anteromedial (AM) bundle injury, posterolateral (PL) bundle injury, complete ACL injury, AM deficiency, PL deficiency, complete ACL rupture, as well as a bone-patellar tendon-bone (BPTB) graft. Generally, the predicted maximum contact pressure and contact area increased for all the ACL injuries when compared to intact ACLs. While an increase in maximum contact pressure and contact area is an indication of an increased risk of the development of OA, the percent of increase was typically small suggesting that walking is a safe activity for individuals with ACL injuries.

OBJECTIVE The purpose of this study was to determine how kinematic, big data can be evaluated using computational, comprehensive analysis of movement parameters in a diverse population. METHODS Retrospective data was collected, cleaned, and reviewed for further analysis of biomechanical movement in an active population using 3D collinear resistance loads. The active sample of the population involved in the study ranged from age 7 to 82 years old and respectively identified as active in 13 different sports. Moreover, a series of exercises were conducted by each participant across multiple sessions. Exercises were measured and recorded based on 6 distinct biometric movement parameters: explosiveness, velocity, power, deceleration, braking, consistency, endurance, and range of motion. Analysis and data visualization portrayed how 3D collinear resistance load impacted specific muscles and performance metrics. RESULTS The model with the highest accuracy rate was Naive Bayes and Fast Large Margin at 58.3% for future predictions considering impact for specific muscles, movement parameters, and performance metric data. The data visualization involved a proof-of-concept human-computer interface and presented each component in relation to one another within the active population database, movement parameters, and performance metrics. DISCUSSION Understanding the findings regarding 3D collinear resistance sets a precedence for future development for the active population and research in the sports analytics field. Additionally, the visual proof of concept interface promotes future development for a diverse, active population.

This thesis proposes an algorithm that determine the geometry of 3D-printed, custom-designed spring element bands made of thermoplastic elastomer (TPE) for use in a wearable orthotic device to aid in the physical therapy of a human hand exhibiting spasticity after stroke. Each finger of the hand is modeled as a mechanical system consisting of a triple-rod pendulum with nonlinear stiffness at each joint and forces applied at the attachment point of each flexor muscle. The system is assumed quasi-static, which leads to a torque balance between the flexor tendons in the hand, joint stiffness and the design force applied to the fingertip by the 3D-printed spring element. To better understand material properties of the spring element’s material, several tests are performed on TPE specimens printed with different infill geometries, including tensile tests and cyclic loading tests. The data and stress-strain curves for each geometry type are presented, which yield a nonlinear relationship between stress and strain as well as apparent hysteresis. Polynomial curves are used to fit the data, which allows for the band geometry to be designed. A hypothetical hand is presented along with how input measurements might be taken for the algorithm. The inputs are entered into the algorithm, and the geometry of the bands for each finger are generated. Results are discussed, and future work is noted, providing a means for the design of a customized orthotic device.

The effects of mechanical forces on endothelial cell function and behavior are well documented, but have not been fully characterized. Specifically, fluid pressure has been shown to elicit physical and chemical responses known to be involved in the initiation and progression of endothelial cell-mediated vascularization. Central to the process of vascularization is the formation of tube-like structures. This process—tubulogenesis—is essential to both the physiological and pathological growth of tissues. Given the known effects of pressure on endothelial cells and its ubiquitous presence in the vasculature, we investigated pressure as a magnitude-dependent parameter for the regulation of endothelial tubulogenic activity. To accomplish this, we exposed two- and three-dimensional bovine aortic endothelial cell (BAEC) cultures to static pressures of 0, 20, and 40 mmHg for 3 and 4 days. The most significant findings were: (1) cells in two-dimensional culture exposed to 20, but not 40, mmHg exhibited significantly (p < 0.05) increased expression of both VEGF-C and VEGFR-3, and (2) cells in three-dimensional culture exposed to 20, but not 40, mmHg exhibited significant (p > 0.05) increases in endothelial sprouting. These findings evidence the utility of pressure as a selective modulator of tissue microvascularization in vitro and implicates pressure as factor in pathological tubulogenesis in vivo.

Articular cartilage injuries occur frequently in the knee joint. Several methods have been implemented clinically, to treat osteochondral defects but none have been able to produce a long term, durable solution. Photopolymerizable cartilage tissue engineering approaches appear promising; however, fundamentally, forming a stable interface between the tissue engineered cartilage and native tissue, mainly subchondral bone and native cartilage, remains a major challenge. The overall objective of this research is to find a solution for the current problem of dislodgment of tissue engineered cartilage at the defect site for the treatment of degraded cartilage that has been caused due to knee injuries or because of mild to moderate level of osteoarthritis. For this, an in-vitro model was created to analyze the integration of tissue engineered cartilage with the bone, healthy and diseased cartilage over time. We investigated the utility of hydroxyapatite (HA) nanoparticles to promote controlled bone-growth across the bone-cartilage interface in an in vitro engineered tissue model system using bone marrow derived stem cells. We also investigated the application of HA nanoparticles to promote enhance integration between tissue engineered cartilage and native cartilage both in healthy and diseased states. Samples incorporated with HA demonstrated significantly higher interfacial shear strength (at the junction between engineered cartilage and engineered bone and also with diseased cartilage) compared to the constructs without HA (p < 0.05), after 28 days of culture. These findings indicate that the incorporation of HA nanoparticles permits more stable anchorage of the injectable hydrogel-based engineered cartilage construct via augmented integration between bone and cartilage.

Older adults may have trouble when performing activities of daily living due to decrease in physical strength and degradation of neuromotor and musculoskeletal function. Motor activation patterns during Lateral Step Down and Step Up from 4-inch and 8-inch step heights was assessed in younger (n=8, 24.4 years) and older adults (n=8, 58.9 years) using joint angle kinematics and electromyography of lower extremity muscles. Ground reaction forces were used to ascertain the loading, stabilization and unloading phases of the tasks. Older adults had an altered muscle activation sequence and significantly longer muscle bursts during loading for the tibialis anterior, gastrocnemius, vastus medialis, bicep femoris, gluteus medius and gluteus maximus muscles of the stationary leg. They also demonstrated a significantly larger swing time (579.1 ms vs. 444.8 ms) during the step down task for the moving leg. The novel data suggests presence of age-related differences in motor coordination during lateral stepping.

This thesis presents a new mechanical design for an exoskeleton actuator to power the sagittal plane motion in the human hip. The device uses a DC motor to drive a Scotch yoke mechanism and series elasticity to take advantage of the cyclic nature of human gait and to reduce the maximum power and control requirements of the exoskeleton. The Scotch yoke actuator creates a position-dependent transmission that varies between 4:1 and infinity, with the peak transmission ratio aligned to the peak torque periods of the human gait cycle. Simulation results show that both the peak and average motor torque can be reduced using this mechanism, potentially allowing a less powerful motor to be used. Furthermore, the motor never needs to reverse direction even when the hip joint does. Preliminary testing shows the exoskeleton can provide an assistive torque and is capable of accurate position tracking at speeds covering the range of human walking. This thesis provides a detailed analysis of how the dynamic nature of human walking can be leveraged, how the hip actuator was designed, and shows how the exoskeleton performed during preliminary human trials.

Fossils belonging to the genus Homo, dating as far back as two million years ago, exhibit uniquely efficient features suggesting that early humans had evolved to become exceptional endurance runners. Although they did not have the cushion or stability-control features provided in our modern day running shoes, our early human ancestors experienced far less of the running-related injuries we experience today. The injury rate has been estimated as high as 90% annually for Americans training for a marathon and as high as 79% annually for all American endurance runners. There is an injury epidemic in conventionally shod populations that does not exist in the habitually unshod or minimally shod populations around the world. This has led many to conclude that the recent advent of highly technological shoes might be the problem. Although current literature has been inconclusive, there are two main limitations in virtually all of the studies: 1) transition phases of less than three months and 2) transition phases without rehabilitation exercises. These two aspects are key to the treatment of the structural consequences on the muscles and tendons of the foot and calf that habitually shod individuals have faced. This study includes a discussion of the cumulative consequences that lifelong shoe usage has on the development of the feet and lower legs. I propose a 78-week study that addresses the limitations of past studies by implementing a gradual, 32-week, multi-shoe transition complemented by an evidence-based rehabilitation program. I believe that this approach will restore strength and elasticity to muscles and tendons that have been inhibited by lifelong usage of overconstructed shoes and adequately prepare runners for the increased demand brought on by a­­­­­ changing running mechanic. This comprehensive, multifaceted transition plan to a fully minimalist shoe will provide novel insight into the ongoing barefoot debate. Can this approach finally demonstrate the proposed benefits of losing the shoes?

Microcirculatory vessels are lined by endothelial cells (ECs) which are surrounded by a single or multiple layer of smooth muscle cells (SMCs). Spontaneous and agonist induced spatiotemporal calcium (Ca2+) events are generated in ECs and SMCs, and regulated by complex bi-directional signaling between the two layers which ultimately determines the vessel tone. The contractile state of microcirculatory vessels is an important factor in the determination of vascular resistance, blood flow and blood pressure. This dissertation presents theoretical insights into some of the important and currently unresolved phenomena in microvascular tone regulation. Compartmental and continuum models of isolated EC and SMC, coupled EC-SMC and a multi-cellular vessel segment with deterministic and stochastic descriptions of the cellular components were developed, and the intra- and inter-cellular spatiotemporal Ca2+ mobilization was examined. Coupled EC-SMC model simulations captured the experimentally observed localized subcellular EC Ca2+ events arising from the opening of EC transient receptor vanilloid 4 (TRPV4) channels and inositol triphosphate receptors (IP3Rs). These localized EC Ca2+ events result in endothelium-derived hyperpolarization (EDH) and Nitric Oxide (NO) production which transmit to the adjacent SMCs to ultimately result in vasodilation. The model examined the effect of heterogeneous distribution of cellular components and channel gating kinetics in determination of the amplitude and spread of the Ca2+ events. The simulations suggested the necessity of co-localization of certain cellular components for modulation of EDH and NO responses. Isolated EC and SMC models captured intracellular Ca2+ wave like activity and predicted the necessity of non-uniform distribution of cellular components for the generation of Ca2+ waves. The simulations also suggested the role of membrane potential dynamics in regulating Ca2+ wave velocity. The multi-cellular vessel segment model examined the underlying mechanisms for the intercellular synchronization of spontaneous oscillatory Ca2+ waves in individual SMC. From local subcellular events to integrated macro-scale behavior at the vessel level, the developed multi-scale models captured basic features of vascular Ca2+ signaling and provide insights for their physiological relevance. The models provide a theoretical framework for assisting investigations on the regulation of vascular tone in health and disease.