La masse corporelle et la direction des charges sont des facteurs qui peuvent modifier la morphologie des surfaces articulaires qui sont généralement orientées et de taille suffisante pour résister aux charges chroniques. Chez les hominoïdes, les forces de tension et compression, générées par la locomotion, sont transmises à travers l’articulation du coude. Ces espèces ont une morphologie similaire de l’extrémité distale de l’humérus, mais qui présente certaines différences selon la taille des individus et leurs modes de locomotion. Ce projet tente de caractériser plus exhaustivement cette variation en analysant la largeur des surfaces articulaires ainsi que leur position et orientation par rapport à l’axe long de la diaphyse. La prémisse de ce mémoire est que, chez les espèces plus arboricoles, la morphologie de l’articulation distale de l’humérus répond aux stress transverses générés par les puissants muscles fléchisseurs du poignet et des doigts qui traversent le coude obliquement. En revanche, les espèces plus terrestres présentent une morphologie permettant de résister aux forces axiales provenant du contact avec le sol. Des coordonnées tridimensionnelles et des mesures linéaires ont été recueillies sur un échantillon squelettique d’individus des genres Homo, Pan, Gorilla et Pongo. Les résultats obtenus révèlent que l’orientation et la position des surfaces articulaires de la trochlée correspondent aux types de locomotion, or leur taille et celle et du capitulum semblent être influencées par la taille des individus. L’hypothèse suggérant que les stress reliés aux divers modes de locomotion des hominoïdes influencent la morphologie de l’articulation distale de l’humérus est donc supportée. / In hominoids, tensile and compressive forces generated by locomotion and upper-limb use are transmitted through the elbow joint. It has been noticed that the distal humerus of hominoid is morphologically very similar across species. However, some studies have suggested that articular shape varies in relation to size and locomotor modes. This project is an attempt to characterize more thoroughly distal humeral variation in hominoids. It considers the humeral trochlea not only as a structure by itself, as it has been done before, but as an articulation that varies in orientation relative to the diaphysis. Indeed, there is evidence that articulations have a minimum size and are generally oriented to better resist habitual loads. This project tested the hypothesis that predominantly arboreal species are expected to present joints that have a size, position and orientation of articular surfaces to better resist shear loads generated by the strong finger and wrist flexor muscles crossing the elbow obliquely. Consequently, predominantly terrestrial species should present articulations shape and orientation that are better to resist axial load generated by ground reaction forces. Ten landmarks and two linear measurements were taken from a skeletal sample including specimens from the Homo, Pan, Gorilla and Pongo genus. Results show that orientation and position of humeral trochlea joint surfaces correlate with locomotor modes and that length of the articular surfaces seems to be better correlated with size. The main hypothesis suggesting that stress related to locomotion in hominoids should influence the morphology of distal humeral joints is therefore supported.

Made available in DSpace on 2016-06-02T20:19:04Z (GMT). No. of bitstreams: 1 DissNTF.pdf: 922511 bytes, checksum: aa3fd5e4f734104cb6412bdf0bc56152 (MD5) Previous issue date: 2007-02-02 / Financiadora de Estudos e Projetos / The purpose of this study was to assess the effects of a weight reduction program on the plantar pressure behavior during standing and walking of obese children. Thirty children, divided into three groups (obese experimental group, obese control group and non obese group), both genders, aged between nine and eleven years old volunteered to this study. The data were collected before and after a weight reduction program with duration of three months. The evaluations included static footprints and plantar pressure variables under six areas of the foot during standing and walking using the Pedar System (Novel GMBh). The results revealed that there was a decrease in the pressures under the midfoot area for the experimental group after the training program, but plantar pressure changes were not observed under other foot areas. An increase in the pressure-time integral was observed after training for the same obese group. In addition, the obese children presented greater contact areas and pressures when compared to non-obese, which can indicate increased risk of injuries due to the excessive load supported by the lower limbs of the obese children. However, the body weight was only poorly related to the plantar pressures, indicating that others factors may interfere on pressure distribution patterns. The correlations between the variables in the midfoot area indicated that it is not possible to assess the dynamic function of the feet from static measures, mainly in obese children, since the excess of adipose tissue in the feet and the medial arch changes may not allow the appropriate interpretation of these measures. Because the plantar pressures measured in this study were not sensitive enough to the training program of three months and, therefore were less influenced by it, the planning of weight reduction programs of longer durations and applied as early as possible is recommended, in order to promote important changes in the plantar pressure behavior and, consequently, to prevent structural and functional disorders in the children s feet. / O objetivo deste estudo foi verificar os efeitos de um programa para redução da massa corporal em crianças obesas sobre o comportamento das pressões plantares e caracterizar os efeitos da obesidade. Foram avaliadas 30 crianças, divididas em três grupos (grupo de obesos experimental, grupo de obesos controle e grupo de eutróficos), de ambos os sexos, com idades entre nove e onze anos. As avaliações foram realizadas antes e depois do programa de intervenção, que teve duração de três meses e incluíram medidas de impressões plantares estáticas e de distribuição de pressão plantar, na postura ereta e na marcha por meio do sistema Pedar (Novel GMBh). A partir dos resultados obtidos constatou-se que o grupo de obesos experimental apresentou diminuição das pressões na região do médio-pé após a intervenção, mas não foram observadas variações das pressões em outras regiões do pé. Um aumento na variável integral pressão-tempo foi observado após a intervenção para o mesmo grupo. As crianças obesas mostraram maiores áreas de contato, pressões e integral pressãotempo quando comparadas às eutróficas, o que pode indicar risco aumentado de lesões, devido à sobrecarga excessiva suportada pelas extremidades inferiores de crianças obesas. Porém, a massa corporal mostrou-se pobremente relacionada com as pressões plantares, indicando que outros fatores podem interferir nos padrões de distribuição de pressão. As correlações entre as variáveis na região do médio-pé indicaram que se deve ter cautela ao inferir a função dinâmica do pé a partir de medidas estáticas, principalmente em crianças obesas, já que o acúmulo de tecido adiposo nos pés e as modificações do arco medial podem dificultar a interpretação dessas medidas. Em virtude da pequena influência do programa de intervenção sobre as variáveis de pressão plantar, recomenda-se o planejamento de programas, com maior tempo de duração e aplicados o mais precocemente possível, a fim de que estes sejam capazes de promover modificações importantes no comportamento das pressões plantares e, dessa forma, prevenir mudanças estruturais e funcionais nos pés de crianças, além de evitar a progressão de outros problemas relacionados à obesidade e melhorar a qualidade de vida dessas crianças.

Made available in DSpace on 2016-06-02T19:22:04Z (GMT). No. of bitstreams: 1 2543.pdf: 1092936 bytes, checksum: 2fe1545577f51cbb0e2fb861e1efb516 (MD5) Previous issue date: 2009-07-16 / Financiadora de Estudos e Projetos / The bone tissue is influenced by internal and external factors and heavy metals, as mercury, are examples of external or environmental factors. The mercury chloride (HgCl2) when absorbed by human body, deposits in the bone and fat tissue and dislocates bones and muscles minerals to circulation, being able to provoke illnesses. In this study, Wistar rats were divided in 4 groups: 3m, 6m, 9m and 12 months (12m) days of life. The animals were treated with HgCl2 or saline through gavage. The treatment began at 30 days of age, 5 times per week, during 60 days. The daily dose was of 0,3mg/Kg of body weight (BW) of HgCl2 and 0,1ml of saline/100g BW. After this period, the group 3m was sacrificed immediately afterwards by decapitation whereas the other groups had remained without treatment until they completed the desired age. The right femurs and vertebrae (L5) were removed for biometrics, physical and biomechanics analysis. The treatment with mercury chloride induced higher values of physical and biometric parameters in the 6m group and lower values in the 12m group and no odifications in the 3 and 9 m groups, when compared with saline treatment. Moreover, the treatment with CM promoted rats vaginal opening with 51 days of life in treated group whereas in the controls this opening occurred in 44,4 days of life.We concluded that the treatment with HgCl2, in the dose of 0,3mg/Kg BW retarded the age at the speed change of the growth of the animals, especially in 6m and 12m groups. Moreover, the HgCl2 promoted bone fragility in animals from 12m group, as can be observed by the analysis of the biometrics, physicals and biomechanics properties, in both femur and vertebrae. The treatment with CM still delayed the sexual maturity of rats. / O tecido ósseo sofre influências de fatores intrínsecos e extrínsecos. Entre os fatores externos ou ambientais, encontram-se os metais pesados, como por exemplo, o mercúrio. O composto cloreto de mercúrio (CM - HgCl2) quando absorvido pelo ser humano, se deposita no tecido ósseo e gorduroso deslocando minerais nobres dos ossos e músculos para a circulação, podendo provocar doenças. Neste estudo, ratas Wistar foram divididas em 4 grupos: 3m, 6m, 9m e 12 meses (12m) de vida. Os animais tratados com mercúrio receberam HgCl2 e os controles, salina por gavagem gástrica. O tratamento iniciou-se aos 30 dias de vida do animal, 5 vezes por semana, durante 60 dias. A dose diária foi de 0,3mg/kg de peso corporal de HgCl2 e de 0,1ml de salina /100g de peso corporal. Após esse período, o grupo 3m foi sacrificado logo em seguida por decapitação enquanto que os demais grupos permaneceram sem tratamento até que completassem a idade desejada. Os animais tiveram seus fêmures direitos e vértebras (L5) retirados para análise dos parâmetros biométricos, físicos e biomecânicos. O tratamento com CM promoveu aumentos dos valores dos parâmetros físicos e biométricos no grupo 6m e redução no grupo 12m, e inalteração nos grupos 3 e 9 meses. Além disso, o tratamento com CM promoveu abertura vaginal das ratas tratadas com CM aos 51 dias de vida enquanto que nos controles essa abertura ocorreu nos 44,4 dias de vida. Concluímos que o tratamento com HgCl2, na dose de 0,3mg/Kg PC retardou a idade em que ocorre a mudança de velocidade do crescimento dos animais, especialmente nos grupos 6m e 12m. Além disso, a contaminação com mercúrio promoveu fragilidade óssea nos animais do grupo 12m, comprovada pela análise das propriedades biométricas, físicas e biomecânicas, tanto dos fêmures como das vértebras, além de atrasar a maturidade sexual das ratas.

La prothèse totale du genou (PTG) est une chirurgie couramment pratiquée pour traiter les patients souffrant d’arthrose sévère du genou. Bien que cette technique chirurgicale soit efficace pour diminuer la douleur, améliorer la fonction du genou et rentable d’un point de vue socio-économique, un pourcentage non négligeable de patients n’est pas satisfait suite à la chirurgie, principalement due à une douleur persistante ou due à une perception d’avoir une mauvaise fonction articulaire, sans cause identifiée. Cependant, l’impact de cette chirurgie sur la cinématique tridimensionnelle (3D) du genou demeure mal compris. Dans le but de mieux comprendre pourquoi certains patients ressentent toujours de la douleur suite à cette chirurgie, cette étude analysera, dans un premier temps, l’effet prospectif de la chirurgie sur la cinématique 3D du genou. Puis dans un second temps, comparera la cinématique 3D de sujet souffrant de douleur à celle de sujets asymptomatiques suite à la prothèse. Pour parvenir à ces deux objectifs, deux études distinctes ont été entreprises. Une première étude prospective a porté sur l’évolution de la cinématique 3D du genou d’un groupe de 19 sujets, recrutés sur la liste d’attente pour prothèse totale du genou de deux chirurgiens du CHUM, hôpital Notre-Dame, puis la cinématique a été comparée avec un groupe contrôle de 17 sujets avec des genoux sains. Une seconde étude a comparé la cinématique 3D de 20 sujets souffrant de douleur post-PTG avec 20 sujets avec des genoux asymptomatiques suite à leur chirurgie. La première étude a permis de montrer que la cinématique dans le plan frontal suite à la prothèse totale du genou était corrigée vers celle des sujets sains. Contrairement à celle mesurée dans les autres plans (sagittal et axial) qui, malgré de petites corrections, demeure différente de la cinématique des sujets sains. La seconde étude a permis d’identifier un marqueur biomécanique de la douleur chez les sujets souffrant de douleur post-PTG. Effectivement, contrairement aux sujets asymptomatiques, suite à leur chirurgie, les patients souffrants de douleur marchent avec une contracture en flexion plus importante tout au long de la phase d’appui. Les résultats de ces deux études tendent à montrer que la prothèse totale du genou modifie la cinématique 3D du genou, sans toutefois redevenir semblable à celle d’un genou normal. De plus, certains marqueurs biomécaniques peuvent être associés à de la douleur suite à la chirurgie. Une meilleure compréhension de l’impact de la PTG sur la cinématique 3D du genou permettra d’offrir de meilleurs traitements en préparation et après la chirurgie et pourrait mener à de nouveaux designs de prothèses. / The total knee arthroplasty (TKA) is a common procedure in patients with severe knee osteoarthritis. This surgery has been proved to reduce pain, to improve knee function, and to be cost-effective. However, an important proportion of patients report insatisfaction, pain, and low articular function following the surgery. Moreover, even with this problem, the impact of the TKA on the tridimensional (3D) kinematics is not well understood. Therefore, two studies have been undertaken with the purpose of using the 3D kinematics to understand the post-TKA pain syndrome. During the first study, 19 subjects, recruited on a TKA waiting list of two surgeons of the CHUM, Hôpital Notre-Dame, were prospectively followed to measure the evolution of their 3D knee kinematics. A control group of 17 subjects with normal knees has also been recruited. The second study has compared 20 subjects with knee pain post-TKA with 20 subjects without pain post-TKA. The results of the first study tend to show an improvement in the frontal plan kinematics after the TKA toward the control group. However, the kinematics in the others plans still different of the control group. When the 3D kinematics of a group with pain is compared to a group without pain (second study), a biomechanical marker associated with pain was identified. The group with pain walk with a higher flexion contracture during the stance phase than the group without pain. Those results show that the total knee arthroplasty has an impact on the 3D kinematics; however, this impact is not necessarily toward the control group. Moreover, some biomechanical markers can be associated with the knee pain following the TKA. This show that we still doesn’t really understand the impact of the TKA on the kinematics, and that a better understanding of this impact could allow the surgeons to improve their care to their patients before and after the surgery.

O edentulismo acomete grande parcela da população mundial, especialmente os idosos, gerando perda da função mastigatória, desordens nutricionais, estética desfavorável e redução da qualidade de vida. Como alternativa a esses problemas, as overdentures implanto retidas tem representado uma modalidade de tratamento eficiente para reabilitação da mandíbula. Assim, o presente estudo teve por objetivo desenvolver e avaliar a efetividade de dois modelos de mini-implantes dentários e um componente protético, cápsula de retenção para overdentures mini-implante retidas. Para tal, um total de 30 mini-implantes (n=10) foram utilizados: modelo comercial Intra-Lock® System, experimental rosqueado e experimental helicoidal. Ambos os mini-implantes desenvolvidos no estudo foram confeccionados em titânio Grau IV, nas dimensões de Ø 2,0 mm x 10 mm de comprimento e submetidos a tratamento de superfície nanométrico. O desempenho dos mesmos foi comparado ao modelo comercial selecionado quanto à estabilidade primária, por meio de torque de inserção e ensaio de arrancamento e à distribuição de tensões, através dos métodos fotoelástico e de correlação de imagens digitais (CID). Foram realizados carregamentos puntiformes axiais e oblíquos (inclinação de 30º do modelo), com cargas de 100 N para a fotoelasticidade e de 250 N axial e 100 N oblíquo para a CID. Para análise do componente protético foi utilizado o teste de resistência à fadiga. 60 cápsulas (n=20): Poliacetal, Politetrafluoretileno (PTFE) e o-ring convencional (Intra-Lock®) foram capturadas aos pares, com resina acrílica e submetidas a 3625 ciclos de inserção/remoção, simulando 30 meses de uso da overdenture. A deformação interna e externa dos componentes foi avaliada por meio de Estereomicroscópio Óptico. Os dados obtidos foram submetidos a ANOVA e teste de Tukey (&alpha;=0,05). O torque de inserção (TI) e ensaio de arrancamento apresentaram significância estatística para todos os modelos (p<0,05), sendo o TI maior para o mini-implante rosqueado e a força máxima de arrancamento para o modelo Intra-Lock®. Quanto à análise de tensões por meio da fotoelasticidade verificou-se de maneira geral, maiores tensões no terço médio e apical dos mini-implantes. O mesmo padrão foi observado para a CID, porém, neste caso, com tensões significativamente maiores (p<0,05) para os mini-implantes rosqueados na condição de carregamento axial, para o oblíquo não foram encontradas diferenças significativas (p>0,05). Quanto à análise dos componentes protéticos, a cápsula de poliacetal apresentou a maior retenção (p<0,05), seguida do o-ring e PTFE. Menor deformação foi observada para o o-ring (p<0,05) e maior deformação interna (p<0,05), após a realização da fadiga, para o poliacetal. O mini-implante rosqueado apresentou de modo geral estabilidade primária e distribuição de tensões comparável ao modelo comercial avaliado. O componente protético de poliacetal demonstrou superioridade em relação ao o-ring da Intra-Lock® quanto à força de retenção e apesar da maior deformação interna sofrida, sugere-se sua substituição após no mínimo 30 meses de uso da overdenture / Edentulism affects a large part of the world population, especially the elderly, generating loss of masticatory function, nutritional disorders, unfavorable esthetics and reduction of quality of life. As an alternative to these problems, overdentures implant retained have represented an efficient treatment modality for mandibular rehabilitation. Thus, the present study aimed to develop and evaluate the effectiveness of two models of dental mini-implants and a prosthetic component, retention caps for overdentures mini-implant retained. To do this, a total of 30 mini-implants (n=10) were used: Intra-Lock® System commercial model, experimental threaded and experimental helical. Both mini-implants developed in the study were made in Titanium Grade IV, in the dimensions of Ø 2.0 mm x 10 mm in length and submitted to a nanometric surface treatment. Their performance were compared to the commercial model selected for primary stability by means of insertion torque and pullout test and stress distribution using photoelastic and digital image correlation (DIC) methods. Axial and oblique punctiform loads (30º inclination of the model) were performed, with loads of 100 N for photoelasticity and 250 N axial and 100 N oblique for DIC. For the analysis of the prosthetic component, the fatigue strength test was used. 60 capsules (n=20): Polyacetal, Polytetrafluoroethylene (PTFE) and conventional O-ring (Intra-Lock®) were captured in pairs with acrylic resin and subjected to 3625 insertion/removal cycles, simulating 30 months of overdenture use. The internal and external deformation of the components was evaluated using an Optical Stereomicroscope. Data were submitted to ANOVA and Tukey\'s test (&alpha;=0.05). The insertion torque (IT) and pullout test were statistically significant for all models (p<0.05), with IT being highest for the threaded mini-implant and maximum pulling force for the Intra-Lock® model. As for stress analysis by photoelasticity, it was generally observed that there were higher tensions in the middle and apical third of the mini-implants. The same pattern was observed for the DIC, but in this case, with significantly higher stresses (p<0.05) for the mini-implants threaded in the axial loading condition, no significant differences were found for the oblique (p>0.05). As for the analysis of prosthetic components, the polyacetal caps presented the highest retention (p<0.05), followed by o-ring and PTFE. Lower deformation was observed for o-ring (p<0.05) and greater internal deformation (p<0.05), after fatigue, for polyacetal. The threaded mini-implant generally showed primary stability and strain distribution comparable to the commercial model evaluated. The polyacetal prosthetic component showed superiority over the Intra-Lock® o-ring for the retention force and despite the greater internal deformation suffered, it is suggested to replace it after at least 30 months of overdenture use

Le bois de tension est un tissu développé par les angiospermes afin de redresser ou de maintenir leur position verticale. Ce tissu génère de fortes contraintes de tension capables de courber un tronc vers le haut. Dans la littérature, l’anatomie du bois de tension est caractérisée par la présence d’une couche gélatineuse (couche G) non lignifiée dans la paroi des fibres. Cette thèse vise à étudier la diversité anatomique du bois de tension ainsi que les mécanismes de génération des contraintes de tension associés et les éventuelles variations de l’efficience du redressement, afin de comprendre comment les arbres se redressent. Elle s’appuie sur des observations anatomiques sur 291 espèces tropicales, sur des estimations de contraintes de maturation sur arbres adultes ainsi que sur une nouvelle méthode d’estimation des contraintes de maturation sur des individus juvéniles artificiellement inclinés et tuteurés en serre. Nos résultats montrent que la couche G est présente dans la majorité des espèces, bien qu’elle soit majoritairement masquée par de la lignine. Dans un faible nombre d’espèces, la couche G est absente du bois de tension. Dans ces espèces, le mécanisme de génération des contraintes de tension implique l’interaction du bois avec l’écorce. Bien que la contrainte de tension soit générée dans des compartiments distincts (le bois et/ou l’écorce), ces deux mécanismes de génération des contraintes de tension ont une efficience de redressement similaire dans le stade juvénile. Les résultats de cette étude ouvrent de nouvelles perspectives de recherche, notamment sur le rôle fonctionnel de la lignine dans la couche G. / Tension wood is a tissue developed by angiosperms to upright or maintain their vertical position. This tissue generates a strong tensile stress able to curve the stem upwards. In the literature, tension wood anatomy is characterized by the presence of an unlignified gelatinous layer (G-layer) in the fibre cell wall. The aims of this thesis are to study the anatomical diversity of tension wood as well as the associated mechanisms of tensile stress generation and eventual variations of uprighting efficiency in order to understand how trees upright. This thesis relies on anatomical observations of 291 tropical species, on estimations of maturation strain on adult trees and on estimations of maturation strain on artificially tilted young trees tied to a pole in a greenhouse. Our results show that the G-layer is present in the majority of the species, although it is mainly hidden by lignin. The G-layer is absent in tension wood of a few number of species. In these species, the mechanism of tensile stress generation involves the interaction of wood and bark. Although tensile stress is generated in separated tissues (wood and/or bark), these two mechanism of tensile stress generation show a similar efficiency of uprighting in juvenile trees. Results of this study open new prospects of research, including on functional role of lignin in the G-layer.

Le disque intervertébral est principalement composé de deux types de tissu : le nucleus pulposus au centre contenu par l'annulus fibrosus en périphérie.Le nucleus est relativement bien décrit dans la littérature contrairement à l'annulus dont la constitution bi-phasique couplée à une structure à fibres orientées reste délicate à modéliser. La caractérisation hydro-chimio-mécanique représente un point clé dans la compréhension des phénomènes qui régissent le comportement de l'organe.Pour répondre au manque d'information, deux axes de travail sont mis en place : expérimental et numérique.La réalisation de tests de traction cyclique associés à des techniques de corrélation d'images permet de fournir une base de données complète du comportement.Elle est ensuite utilisée pour identifier un modèle hydro-chimio-mécanique qui traduit le comportement non-linéaire, anisotrope, dissipatif ainsi que la sensibilité aux variations d'environnement chimique du tissu observés expérimentalement.L'intérêt majeur de cette méthode est l'identification simultanée de l'ensemble des paramètres du modèle au cours de sollicitations proches des conditions physiologiques sur chacune des éprouvettes.Ce protocole réduit ainsi les incertitudes liées aux variabilités inter-individus et inter-localisations pour obtenir des valeurs de paramètres plus fiables.La formulation identifiée permettra de proposer un modèle compréhensif des transferts de fluide impliqués dans les processus de nutrition cellulaire.Ce sujet s'intègre dans une réflexion plus large relative à la compréhension des couplages hydro-chimio-mécaniques dans les tissus biologiques.L'enjeu est de quantifier l'impact des stimuli mécaniques sur l'évolution des tissus humains et leur adaptation aux conditions environnementales. / Intervertebral disc is mainly divided into two parts : nucleus pulposus surrounding by annulus fibrosus.Nucleus is relatively well described in literature, on the other hand annulus remains difficult to model due to its bi-phasic constitution coupled with an oriented fibres structure.Hydro-chemo-mechanical characterization represent a key point to reach a better understanding of this organ.To overcome this lack of knowledge, two axes are developed in this work : experimental and numerical.Cyclic tensile tests associated to digital image correlation techniques allow to obtain a large amount of data on global tissue behaviour.It permit to identify a hydro-chemo-mechanical model which takes in account the non-linear, anisotropic and dissipative behaviours.It also highlights sensibility to chemical variations in tissue environment observed experimentally.The most important point of this work is the simultaneous parameter identification performed on each sample during solicitations similar to in vivo conditions.This protocol reduce inter-individuals and inter-localisations discrepancies and leads to an accurate bundle of parameters.The formulation aims to accurately model fluid motion inside intervertebral disc tissues which is related to cell nutrition, growth and homoeostasis.This work is involved in a larger problematic about hydro-chemo-mechanical coupling within biological tissues.It will allow to quantify mechanical stimuli influence on human tissues evolution and adaptation to environment conditions.

Le complexe muscle-tendon est constitué d’une composante élastique série fondamentale à son fonctionnement. Cette composante élastique série est composée d’une fraction active située au sein du sarcomère et d’une fraction passive formée par les tissus tendineux (tendon et aponévrose). Elle a un rôle majeur pour optimiser le mouvement en améliorant le rendement énergétique du muscle et le travail produit.La mise au point d’une nouvelle méthode couplant une technique de détente rapide (Quick release) et un échographe haute fréquence a permis de quantifier les contributions de compliance des structures élastiques séries (tendon, aponévrose et fascicules musculaires) à la compliance globale du complexe muscle-tendon en condition active lors d’un test de détente rapide. Les résultats de la première étude montrent que le tendon a une contribution de compliance majoritaire (environ 72 %) tandis que les fascicules musculaires et l’aponévrose contribuent respectivement à 18 % et 10 %. Le tendon confirme donc son rôle capital dans la compliance de la composante élastique série en condition active. De plus, les contributions constantes du tendon, des fascicules musculaires et de l’aponévrose observées aux différents niveaux de couple pourraient aider à simplifier le mécanisme de régulation de la compliance et à maintenir le rôle majeur du tendon dans l’efficience du mouvement.Cette nouvelle méthode a permis d’étudier les adaptations mécaniques de la composante élastique série à la variation de la demande fonctionnelle, notamment en quantifiant les modifications des contributions relatives de compliance des structures élastiques séries chez des escrimeurs élites dans la deuxième étude puis chez des sujets spastiques dans la troisième étude. Concernant les escrimeurs élite, les résultats montrent que les contributions de compliance des structures élastiques de la jambe dominante du groupe d’escrimeurs sont significativement différentes à celles correspondant à la jambe du groupe contrôle, avec notamment une part plus importante de contribution pour l’aponévrose (21,1 vs 15,9 %) et une part minorée pour les fascicules (9,5 vs 13,8 %) concernant la jambe dominante des escrimeurs. En revanche, la contribution du tendon (environ 70 %) est identique pour les deux jambes. Ces modifications tendent à majorer le rôle des tissus tendineux (tendon et aponévrose) et à minorer le rôle des fascicules musculaires ce qui permettrait une utilisation supérieure des structures élastiques tendineuses pour un meilleur rendement énergétique et une performance accrue. Il est possible que l'aponévrose soit un système complémentaire à l’adaptation du complexe muscle-tendon en cas d'hyperactivité.La troisième étude est devenue une étude de cas en raison de la difficulté à tester les patients spastiques sur le Quick release. Elle s’est portée sur un patient spastique dont l’atteinte motrice était plus faible que les autres et a montré des contributions relatives de compliance du tendon (75,3 %) et de l’aponévrose (15,2 %) supérieures à celle des fascicules (9,5 %) Ce résultat s’expliquerait par une augmentation de la raideur du muscle et une diminution de la raideur des tissus tendineux observées classiquement dans les études menées sur des sujets spastiques. / The muscle-tendon complex contains a serie elastic component which is fundamental to its functioning. This serie elastic component is composed of an active part located within the sarcomere and a passive part located in the tendon and aponeurosis. It has a major role to optimize the movement by improving the muscle energetic efficiency and the produced work.A new method coupling a quick release ergometer and a high frequency ultrasound device was used to quantify the compliance contributions of the series elastic structures (tendon, aponeurosis and muscle fascicles) to the global compliance of the muscle-tendon complex in active conditions. The results of the first study showed that the tendon has a major compliance contribution (about 72%) while the muscle fascicles and aponeurosis contributions are 18% and 10%, respectively. The tendon confirms its key role in the compliance of the serie elastic component in active condition. In addition, the constant contributions of tendon, muscle fascicles and aponeurosis observed at various levels of torque may help simplify the regulation mechanism of compliance and maintain the major role of the tendon in the efficiency of the movement.This new method was also used to study the mechanical adaptations of the serie elastic component to variation of the functional demand. The changes in the relative compliance contributions of series elastic structures were quantified in elite fencers in the second study and in spastic subjects in the third study. Regarding the elite fencers, the results showed that the compliance contributions of the elastic structures in the dominant leg of fencers group were significantly different to those corresponding to the leg of the control group. The aponeurosis compliance contribution was higher for the dominant leg of the fencers groupe (21.1 vs 15.9%) while the muscle fascicles contribution was lower for the fencers group (9.5 vs 13.8%). The tendon contribution (about 70%) was the same for both legs. These changes tend to increase the role of tendon tissue (tendon and aponeurosis) and decrease the role of muscle fascicles which would allow greater use of tendon elastic structures for better energetic efficiency and improved performance. It is possible that aponeurosis is a complementary system to the adaptation of the muscle-tendon complex in the case of hyperactivity.The third study has become a case study because of the difficulty in testing the spastic patients on Quick release. Finally, the study has been done on a spastic patient with minor motor impairment compared to the others patients. The results showed a tendon and aponeurosis compliance contributions (75.3% and 15.2% respectively) higher than the muscle fascicles compliance contribution (9.5%). This result may be explained by an increase in muscle stiffness and a decrease in tendon stiffness, which is classically observed in studies with spastic subjects.

Although dynamic prosthetic alignment is an important process for the rehabilitation of transtibial amputees, such alignment technique is subjective and inconsistent. Using biomechanical variables and questionnaire assessments, this study compared an instrument-assisted dynamic alignment technique using the Compas™ system and conventional alignment techniques on nine adults with unilateral transtibial amputation. A focus group discussion was conducted with six prosthetists to understand clinical practice of dynamic alignment and their perception of the Compas™ system. Results found that Compas™ produced more anterior weight line displacement and greater varus moment on the prosthesis than conventional alignment techniques. Alignment changes did not affect pelvic acceleration, and the instrument-assisted alignment technique produced certain biomechanical changes but not necessarily better alignments. Although the current version of the Compas™ system is not clinically feasible, it can be used as a teaching/justification tool. Further investigation with larger sample size and ankle alignment or moment measures is needed.

Although dynamic prosthetic alignment is an important process for the rehabilitation of transtibial amputees, such alignment technique is subjective and inconsistent. Using biomechanical variables and questionnaire assessments, this study compared an instrument-assisted dynamic alignment technique using the Compas™ system and conventional alignment techniques on nine adults with unilateral transtibial amputation. A focus group discussion was conducted with six prosthetists to understand clinical practice of dynamic alignment and their perception of the Compas™ system. Results found that Compas™ produced more anterior weight line displacement and greater varus moment on the prosthesis than conventional alignment techniques. Alignment changes did not affect pelvic acceleration, and the instrument-assisted alignment technique produced certain biomechanical changes but not necessarily better alignments. Although the current version of the Compas™ system is not clinically feasible, it can be used as a teaching/justification tool. Further investigation with larger sample size and ankle alignment or moment measures is needed.