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Huang Y, Ho KHM, Christensen M, Wong DWC, Wang S, Su JJ, Zhao IY, Kor PPK, Liu JYW, Cheung JCW, Leung AYM, Cheung DSK. Virtual reality-based simulation intervention for enhancing the empathy of informal caregivers of people with dementia: A mixed-methods systematic review. Int J Ment Health Nurs 2024; 33:241-258. [PMID: 37817470 DOI: 10.1111/inm.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/25/2023] [Accepted: 09/24/2023] [Indexed: 10/12/2023]
Abstract
Dementia is a long-term and progressive syndrome that not only influences the person with dementia (PWD) but also the caregiver. However, informal caregivers are not always empathic and understand the symptoms of dementia, leading to destructive caregiving relationships and poor quality of caregiving. VR-based simulation interventions can provide a more realistic and memorable learning experience for caregivers to walk in PWDs' shoes. This review aimed to provide practitioners and researchers with insights on developing and/or adopting an effective VR-based simulation intervention for enhancing the empathy of informal caregivers of PWD. A mixed-methods systematic review was conducted. Quantitative, qualitative, and mixed-methods studies were searched from MEDLINE, PsycINFO, CINAHL, Scopus, Embase, and Cochrane Library updating. Standard JBI critical appraisal instruments were used for the quality appraisal. A convergent segregated approach was used to synthesize and integrate the data. A total of seven studies were included. Inconsistent quantitative results were reported on the effects of VR-based simulation on empathy enhancement. Significant effects were reported on knowledge of dementia and emotion-focused coping strategies. Two themes were generated from the qualitative studies, including "Informal caregivers gained better insight into problems encountered by older people with dementia" and "Thinking from the perspective of older people with dementia, leading to changes in attitudes and behaviours towards dementia". The qualitative synthesized evidence showed that informal caregivers gained better insight into problems encountered by PWD, but the quantitative synthesized results are inconsistent. Yet, informal caregivers experienced a change in attitude by thinking from the perspective of PWD.
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Affiliation(s)
- Yaqi Huang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ken Hok Man Ho
- Nethersole School of Nursing, The Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Martin Christensen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Interdisciplinary Centre for Qualitative Research, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ivy Yan Zhao
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Patrick Pui Kin Kor
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Angela Yee Man Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Wang Y, Chen Q, Liu L, He Q, Cheung JCW, Wong DWC, Liu Y, Lam WK. Training effects of set- and repetition-interval rest time on recumbent-boxing exercise: Could virtual reality improve further? iScience 2023; 26:107399. [PMID: 37575198 PMCID: PMC10415930 DOI: 10.1016/j.isci.2023.107399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
This study examined the influence of set-interval and repetition-interval rest time of virtual reality (VR) boxing game in supine-lying posture. Fifty healthy middle-aged adults were randomly assigned into VR and non-VR groups to perform six different exercise protocols with varying set-interval and repetition-interval rest times (S0R0, S0R1/3, S0R2/3, S40R0, S40R1/3, and S40R2/3). Analysis on the non-VR group showed significant differences between exercise protocols for average heart rate (p < 0.001), maximum ventilation volume (p < 0.001), respiratory quotient (p < 0.001), oxygen pulse (p < 0.001), and excess post-exercise oxygen consumption (EPOC) (p = 0.003). VR appeared to have no further improvement on physical training effects in middle-aged adults, while the participants reported negative experience that might be associated with the over-exertion. Future study might need to explore game design elements that can accommodate high-exertion exercises.
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Affiliation(s)
- Yi Wang
- Department of Physical Education, Renmin University of China, Beijing 100872, China
- Sports and Social Development Research Center, Renmin University of China, Beijing 100872, China
| | - Qi Chen
- Physical Education Department, University of International Business and Economics, Beijing 100029, China
| | - Liangchao Liu
- Physical Education Department, University of International Business and Economics, Beijing 100029, China
| | - Qiuhong He
- School of Physical Education, Changzhou University, Changzhou 213164, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Yang Liu
- L&L Technology PTY Company Limited, Cheltenham, VIC 3192, Australia
- School of Mechanics and Safety Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Center, Hong Kong Sports Institute, Hong Kong 999077, China
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Cheng ESW, Lai DKH, Mao YJ, Lee TTY, Lam WK, Cheung JCW, Wong DWC. Computational Biomechanics of Sleep: A Systematic Mapping Review. Bioengineering (Basel) 2023; 10:917. [PMID: 37627802 PMCID: PMC10451553 DOI: 10.3390/bioengineering10080917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Biomechanical studies play an important role in understanding the pathophysiology of sleep disorders and providing insights to maintain sleep health. Computational methods facilitate a versatile platform to analyze various biomechanical factors in silico, which would otherwise be difficult through in vivo experiments. The objective of this review is to examine and map the applications of computational biomechanics to sleep-related research topics, including sleep medicine and sleep ergonomics. A systematic search was conducted on PubMed, Scopus, and Web of Science. Research gaps were identified through data synthesis on variants, outcomes, and highlighted features, as well as evidence maps on basic modeling considerations and modeling components of the eligible studies. Twenty-seven studies (n = 27) were categorized into sleep ergonomics (n = 2 on pillow; n = 3 on mattress), sleep-related breathing disorders (n = 19 on obstructive sleep apnea), and sleep-related movement disorders (n = 3 on sleep bruxism). The effects of pillow height and mattress stiffness on spinal curvature were explored. Stress on the temporomandibular joint, and therefore its disorder, was the primary focus of investigations on sleep bruxism. Using finite element morphometry and fluid-structure interaction, studies on obstructive sleep apnea investigated the effects of anatomical variations, muscle activation of the tongue and soft palate, and gravitational direction on the collapse and blockade of the upper airway, in addition to the airflow pressure distribution. Model validation has been one of the greatest hurdles, while single-subject design and surrogate techniques have led to concerns about external validity. Future research might endeavor to reconstruct patient-specific models with patient-specific loading profiles in a larger cohort. Studies on sleep ergonomics research may pave the way for determining ideal spine curvature, in addition to simulating side-lying sleep postures. Sleep bruxism studies may analyze the accumulated dental damage and wear. Research on OSA treatments using computational approaches warrants further investigation.
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Affiliation(s)
- Ethan Shiu-Wang Cheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Department of Electronic and Information Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Timothy Tin-Yan Lee
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong
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Lai DKH, Cheng ESW, Mao YJ, Zheng Y, Yao KY, Ni M, Zhang YQ, Wong DWC, Cheung JCW. Sonoelastography for Testicular Tumor Identification: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy. Cancers (Basel) 2023; 15:3770. [PMID: 37568585 PMCID: PMC10417060 DOI: 10.3390/cancers15153770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
The objective of this review was to summarize the applications of sonoelastography in testicular tumor identification and inquire about their test performances. Two authors independently searched English journal articles and full conference papers from CINAHL, Embase, IEEE Xplore®, PubMed, Scopus, and Web of Science from inception and organized them into a PIRO (patient, index test, reference test, outcome) framework. Eleven studies (n = 11) were eligible for data synthesis, nine of which (n = 9) utilized strain elastography and two (n = 2) employed shear-wave elastography. Meta-analyses were performed on the distinction between neoplasm (tumor) and non-neoplasm (non-tumor) from four study arms and between malignancy and benignity from seven study arms. The pooled sensitivity of classifying malignancy and benignity was 86.0% (95%CI, 79.7% to 90.6%). There was substantial heterogeneity in the classification of neoplasm and non-neoplasm and in the specificity of classifying malignancy and benignity, which could not be addressed by the subgroup analysis of sonoelastography techniques. Heterogeneity might be associated with the high risk of bias and applicability concern, including a wide spectrum of testicular pathologies and verification bias in the reference tests. Key technical obstacles in the index test were manual compression in strain elastography, qualitative observation of non-standardized color codes, and locating the Regions of Interest (ROI), in addition to decisions in feature extractions. Future research may focus on multiparametric sonoelastography using deep learning models and ensemble learning. A decision model on the benefits-risks of surgical exploration (reference test) could also be developed to direct the test-and-treat strategy for testicular tumors.
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Affiliation(s)
- Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ethan Shiu-Wang Cheng
- Department of Electronic and Information Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yi Zheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ke-Yu Yao
- Department of Materials, Imperial College, London SW7 2AZ, UK
| | - Ming Ni
- Department of Orthopaedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
- Laboratory of Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Ying-Qi Zhang
- Department of Orthopaedics, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
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Lai DKH, Cheng ESW, Lim HJ, So BPH, Lam WK, Cheung DSK, Wong DWC, Cheung JCW. Computer-aided screening of aspiration risks in dysphagia with wearable technology: a Systematic Review and meta-analysis on test accuracy. Front Bioeng Biotechnol 2023; 11:1205009. [PMID: 37441197 PMCID: PMC10334490 DOI: 10.3389/fbioe.2023.1205009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Aspiration caused by dysphagia is a prevalent problem that causes serious health consequences and even death. Traditional diagnostic instruments could induce pain, discomfort, nausea, and radiation exposure. The emergence of wearable technology with computer-aided screening might facilitate continuous or frequent assessments to prompt early and effective management. The objectives of this review are to summarize these systems to identify aspiration risks in dysphagic individuals and inquire about their accuracy. Two authors independently searched electronic databases, including CINAHL, Embase, IEEE Xplore® Digital Library, PubMed, Scopus, and Web of Science (PROSPERO reference number: CRD42023408960). The risk of bias and applicability were assessed using QUADAS-2. Nine (n = 9) articles applied accelerometers and/or acoustic devices to identify aspiration risks in patients with neurodegenerative problems (e.g., dementia, Alzheimer's disease), neurogenic problems (e.g., stroke, brain injury), in addition to some children with congenital abnormalities, using videofluoroscopic swallowing study (VFSS) or fiberoptic endoscopic evaluation of swallowing (FEES) as the reference standard. All studies employed a traditional machine learning approach with a feature extraction process. Support vector machine (SVM) was the most famous machine learning model used. A meta-analysis was conducted to evaluate the classification accuracy and identify risky swallows. Nevertheless, we decided not to conclude the meta-analysis findings (pooled diagnostic odds ratio: 21.5, 95% CI, 2.7-173.6) because studies had unique methodological characteristics and major differences in the set of parameters/thresholds, in addition to the substantial heterogeneity and variations, with sensitivity levels ranging from 21.7% to 90.0% between studies. Small sample sizes could be a critical problem in existing studies (median = 34.5, range 18-449), especially for machine learning models. Only two out of the nine studies had an optimized model with sensitivity over 90%. There is a need to enlarge the sample size for better generalizability and optimize signal processing, segmentation, feature extraction, classifiers, and their combinations to improve the assessment performance. Systematic Review Registration: (https://www.crd.york.ac.uk/prospero/), identifier (CRD42023408960).
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Affiliation(s)
- Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ethan Shiu-Wang Cheng
- Department of Electronic and Information Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hyo-Jung Lim
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute Ltd, Hong Kong, China
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
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Lai DKH, Zha LW, Leung TYN, Tam AYC, So BPH, Lim HJ, Cheung DSK, Wong DWC, Cheung JCW. Corrigendum to ‘Dual ultra-wideband (UWB) radar-based sleep posture recognition system: Towards ubiquitous sleep monitoring’[Engineered Regeneration 4 (2023) 36 – 43]. Engineered Regeneration 2023. [DOI: 10.1016/j.engreg.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Wang Y, Liu L, Chen Q, Gao K, Wang H, Xu N, Chen Y, Wong DWC, Lam WK. Modified lumbo-pelvic exercise to alleviate mild stress urinary incontinence in middle-aged females. Sci Rep 2023; 13:7142. [PMID: 37130891 PMCID: PMC10153777 DOI: 10.1038/s41598-023-34417-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/29/2023] [Indexed: 05/04/2023] Open
Abstract
Urinary incontinence is one of the common clinical problems of females passing middle age. Traditional pelvic floor muscle training to alleviate urinary incontinence is too dull and unpleasant. Therefore, we were motivated to purpose a modified lumbo-pelvic exercise training incorporating simplified dancing components with pelvic floor muscle training. The objective of this study was to evaluate the 16-week modified lumbo-pelvic exercise program that incorporated dance and abdominal drawing-in maneuvers. Middle-aged females were randomly assigned into the experimental (n = 13) and control (n = 11) groups. Compared to the control group, the exercise group significantly reduced body fat, visceral fat index, waistline, waist-hip ratio, perceived incontinence score, frequency of urine leakage, and pad testing index (p < 0.05). In addition, there were significant improvements in pelvic floor function, vital capacity, and muscle activity of the right rectus abdominis (p < 0.05). This indicated that the modified lumbo-pelvic exercise program can promote benefits of physical training and alleviate urinary incontinence in middle-aged females.
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Affiliation(s)
- Yi Wang
- Department of Physical Education, Renmin University of China, Beijing, China
- Sports and Social Development Research Center, Renmin University of China, Beijing, China
| | - Liangchao Liu
- Physical Education Department, University of International Business and Economics, Beijing, China
| | - Qi Chen
- Physical Education Department, University of International Business and Economics, Beijing, China
| | - Kuiting Gao
- School of Physical Education, Shandong University of Technology, Shandong, China.
| | - Hongchu Wang
- School of Mathematical Sciences, South China Normal University, Guangzhou, China
| | - Naxin Xu
- Sport Science School, Beijing Sport University, Beijing, China
| | - Yinru Chen
- College of Education, Beijing Sport University, Beijing, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong, China.
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Wong DWC, Zhang M, Yu J, Leung AKL. Corrigendum to 'Biomechanics of first ray hypermobility: An investigation on joint force during walking using finite element analysis'. [Med. Eng. Phys. 36(2014) 1388-1393]. Med Eng Phys 2023; 116:103984. [PMID: 37179222 DOI: 10.1016/j.medengphy.2023.103984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Duo Wai-Chi Wong
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jia Yu
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China; Orthopaedic Institute, Soochow University, Suzhou, Jiangsu, China
| | - Aaron Kam-Lun Leung
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
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Lai DKH, Yu ZH, Leung TYN, Lim HJ, Tam AYC, So BPH, Mao YJ, Cheung DSK, Wong DWC, Cheung JCW. Vision Transformers (ViT) for Blanket-Penetrating Sleep Posture Recognition Using a Triple Ultra-Wideband (UWB) Radar System. Sensors (Basel) 2023; 23:2475. [PMID: 36904678 PMCID: PMC10006965 DOI: 10.3390/s23052475] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Sleep posture has a crucial impact on the incidence and severity of obstructive sleep apnea (OSA). Therefore, the surveillance and recognition of sleep postures could facilitate the assessment of OSA. The existing contact-based systems might interfere with sleeping, while camera-based systems introduce privacy concerns. Radar-based systems might overcome these challenges, especially when individuals are covered with blankets. The aim of this research is to develop a nonobstructive multiple ultra-wideband radar sleep posture recognition system based on machine learning models. We evaluated three single-radar configurations (top, side, and head), three dual-radar configurations (top + side, top + head, and side + head), and one tri-radar configuration (top + side + head), in addition to machine learning models, including CNN-based networks (ResNet50, DenseNet121, and EfficientNetV2) and vision transformer-based networks (traditional vision transformer and Swin Transformer V2). Thirty participants (n = 30) were invited to perform four recumbent postures (supine, left side-lying, right side-lying, and prone). Data from eighteen participants were randomly chosen for model training, another six participants' data (n = 6) for model validation, and the remaining six participants' data (n = 6) for model testing. The Swin Transformer with side and head radar configuration achieved the highest prediction accuracy (0.808). Future research may consider the application of the synthetic aperture radar technique.
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Affiliation(s)
- Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Zi-Han Yu
- School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Tommy Yau-Nam Leung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Hyo-Jung Lim
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Andy Yiu-Chau Tam
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China
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Wong DWC, Cheung JCW, Zhao JG, Ni M, Yang ZY. Forefoot Function after Hallux Valgus Surgery: A Systematic Review and Meta-Analysis on Plantar Load Measurement. J Clin Med 2023; 12:jcm12041384. [PMID: 36835920 PMCID: PMC9965975 DOI: 10.3390/jcm12041384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
While hallux valgus (HV) surgeries are useful for correcting skeletal alignment problems, their effects on plantar load, which reflects forefoot functions, are less understood. The objective of this study is to conduct a systematic review and meta-analysis on the plantar load change after HV surgeries. A systematic search of Web of Science, Scopus, PubMed, CENTRAL, EMBASE, and CINAHL was performed. Studies that assessed the pre- and post-operative plantar pressure of HV patients undergoing surgeries and reported load-related parameters over the hallux, medial metatarsal, and/or central metatarsal regions were included. Studies were appraised by using the modified NIH quality assessment tool for before-after study. Studies suitable for meta-analysis were pooled with the random-effects model, using the standardized mean difference of the before-after parameters as an effect measure. Twenty-six studies containing 857 HV patients and 973 feet were included for the systematic review. Meta-analysis was conducted on 20 of them, and most studies did not favor HV surgeries. Overall, HV surgeries reduced the plantar load over the hallux region (SMD -0.71, 95% CI, -1.15 to -0.26), indicating that forefoot function worsened after surgeries. For the other five outcomes, the overall estimates were not statistically significant, indicating that surgeries did not improve them either. There was substantial heterogeneity among the studies, which in most cases could not be resolved by pre-planned subgroup analyses by surgical classification, year of publication, median age of patients, and length of follow-up. Sensitivity analysis removing lower-quality studies showed that the load integrals (impulse) over the central metatarsal region significantly increased (SMD 0.27, 95% CI, 0 to 0.53), indicating that surgeries increased the risk of transfer metatarsalgia. There is no solid evidence that HV surgeries could improve forefoot functions from a biomechanical point perspective. Currently available evidence even suggests that surgeries might reduce the plantar load over the hallux and adversely affect push-off function. The reasons behind and the effectiveness of alternative surgical methods warrant further investigation.
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Affiliation(s)
- Duo Wai-Chi Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - James Chung-Wai Cheung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Jia-Guo Zhao
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin 300211, China
| | - Ming Ni
- Department of Science Development, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
- Department of Orthopaedics, Pudong New Area People’s Hospital, Shanghai 201299, China
| | - Zu-Yao Yang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
- Correspondence: ; Tel.: +852-2252-8739
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Lim HJ, Lai DKH, So BPH, Yip CCK, Cheung DSK, Cheung JCW, Wong DWC. A Comprehensive Assessment Protocol for Swallowing (CAPS): Paving the Way towards Computer-Aided Dysphagia Screening. Int J Environ Res Public Health 2023; 20:2998. [PMID: 36833691 PMCID: PMC9963613 DOI: 10.3390/ijerph20042998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Dysphagia is one of the most common problems among older adults, which might lead to aspiration pneumonia and eventual death. It calls for a feasible, reliable, and standardized screening or assessment method to prompt rehabilitation measures and mitigate the risks of dysphagia complications. Computer-aided screening using wearable technology could be the solution to the problem but is not clinically applicable because of the heterogeneity of assessment protocols. The aim of this paper is to formulate and unify a swallowing assessment protocol, named the Comprehensive Assessment Protocol for Swallowing (CAPS), by integrating existing protocols and standards. The protocol consists of two phases: the pre-test phase and the assessment phase. The pre-testing phase involves applying different texture or thickness levels of food/liquid and determining the required bolus volume for the subsequent assessment. The assessment phase involves dry (saliva) swallowing, wet swallowing of different food/liquid consistencies, and non-swallowing (e.g., yawning, coughing, speaking, etc.). The protocol is designed to train the swallowing/non-swallowing event classification that facilitates future long-term continuous monitoring and paves the way towards continuous dysphagia screening.
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Affiliation(s)
- Hyo-Jung Lim
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
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So BPH, Chan TTC, Liu L, Yip CCK, Lim HJ, Lam WK, Wong DWC, Cheung DSK, Cheung JCW. Swallow Detection with Acoustics and Accelerometric-Based Wearable Technology: A Scoping Review. Int J Environ Res Public Health 2022; 20:170. [PMID: 36612490 PMCID: PMC9819201 DOI: 10.3390/ijerph20010170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Swallowing disorders, especially dysphagia, might lead to malnutrition and dehydration and could potentially lead to fatal aspiration. Benchmark swallowing assessments, such as videofluoroscopy or endoscopy, are expensive and invasive. Wearable technologies using acoustics and accelerometric sensors could offer opportunities for accessible and home-based long-term assessment. Identifying valid swallow events is the first step before enabling the technology for clinical applications. The objective of this review is to summarize the evidence of using acoustics-based and accelerometric-based wearable technology for swallow detection, in addition to their configurations, modeling, and assessment protocols. Two authors independently searched electronic databases, including PubMed, Web of Science, and CINAHL. Eleven (n = 11) articles were eligible for review. In addition to swallowing events, non-swallowing events were also recognized by dry (saliva) swallowing, reading, yawning, etc., while some attempted to classify the types of swallowed foods. Only about half of the studies reported that the device attained an accuracy level of >90%, while a few studies reported poor performance with an accuracy of <60%. The reviewed articles were at high risk of bias because of the small sample size and imbalanced class size problem. There was high heterogeneity in assessment protocol that calls for standardization for swallowing, dry-swallowing and non-swallowing tasks. There is a need to improve the current wearable technology and the credibility of relevant research for accurate swallowing detection before translating into clinical screening for dysphagia and other swallowing disorders.
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Affiliation(s)
- Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Tim Tin-Chun Chan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Liangchao Liu
- Physical Education Department, University of International Business and Economics, Beijing 100029, China
| | | | - Hyo-Jung Lim
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong
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Wong DWC, Wang Y, Niu W, Zhang M. Response to the letter to editor regarding "finite element analysis of subtalar joint arthroereisis on adult acquired flexible flatfoot deformity using customized sinus tarsi implant". J Orthop Translat 2022; 37:173-174. [PMID: 36569456 PMCID: PMC9747350 DOI: 10.1016/j.jot.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China,Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong, China,Corresponding author. Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China,Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wenxin Niu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China,Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong, China,Corresponding author. Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
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Xu Z, Sun W, Li P, Wang Y, Wong DWC, Cheung JCW, Niu W, Zhang H, Ni M. Modified Ni-Nail and C-Nail systems for intra-articular fractures of the calcaneus: A biomechancial study. Injury 2022; 53:3904-3911. [PMID: 36182591 DOI: 10.1016/j.injury.2022.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES We have proposed a novel intramedullary nail (Ni-Nail) by incorporating a sustentaculum tali screw to improve the fixation stability of minimally invasive treatment for calcaneal fractures. This study aimed to evaluate the biomechanical characters of the Ni-Nail system and compare it with traditional C-Nail system. METHODS A finite element model of a Sanders type-IIIAB calcaneal fracture was reconstructed and fixed using two intramedullary nail systems, which was validated by a cadaver study. A vertical loading of 700 N was applied to the subtalar joint surfaces, and 525 N Achilles tendon tension was applied to the superior border of the Achilles tuberosity. The von Mises stresses and fracture displacements of both fixation models were evaluated. RESULTS The maximum von Mises stress of the screws of Ni-Nail and C-Nail were 27.92 MPa and 57.42 MPa, respectively, while that of the main nail were 67.44 MPa and 53.01 MPa. In addition, the maximum fracture displacement of the Ni-Nail was larger than that of C-Nail by 15.6% (0.37 mm vs.0.32 mm). CONCLUSIONS Our static simulation analysis showed that both Ni-Nail and C-Nail demonstrated similar biomechanical stability for calcaneal fixation. The Ni-Nail features a simple structure that is easier to operate and less traumatizing. Future studies may consider to further evaluate the clinical effectiveness by clinical trials and follow-ups.
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Affiliation(s)
- Zihuan Xu
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Wanju Sun
- Department of Orthopaedics, Shanghai Pudong New Area Peoples' Hospital, Shanghai 201299, China
| | - Pengfei Li
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Yongqin Wang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Wenxin Niu
- Yangzhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai 201619 China; Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Haowei Zhang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China.
| | - Ming Ni
- Department of Orthopaedics, Shanghai Pudong New Area Peoples' Hospital, Shanghai 201299, China; Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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Wang Y, Guo X, Wang H, Chen Y, Xu N, Xie M, Wong DWC, Lam WK. Training and retention effects of paced and music-synchronised walking exercises on pre-older females: an interventional study. BMC Geriatr 2022; 22:895. [PMID: 36424532 PMCID: PMC9685952 DOI: 10.1186/s12877-022-03598-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Physical activity at pre-older ages (55-64 years) can greatly affect one's physical fitness, health, physical-activity behaviour, and quality of life at older ages. The objective of this study was to conduct a 24-week walking-exercise programme among sedentary pre-older females and investigate the influence of different walking cadences on cardiorespiratory fitness and associated biomarkers. METHODS A total of 78 pre-older sedentary female participants were recruited and randomly assigned to normal (n = 36), paced (n = 15), music-synchronised (n = 15) walking, and no-exercise control (n = 12) groups, respectively. The normal, paced, and music-synchronised walking groups walked at a cadence of 120 steps/min, 125 steps/min, and 120-128 steps/min, respectively, under supervised conditions. Anthropometric characteristics, step length, nutrient intake, blood pressure and composition, and cardiorespiratory fitness were measured at baseline, the 12th week of the programme, the 24th week of the programme (completion), and after a 12-week retention period, which began immediately upon completion of the programme and did not feature any supervised exercises. RESULTS All walking conditions improved high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, step length, maximum oxygen consumption (VO2max), and oxidative capacity at anaerobic threshold (all P < 0.001); however, after the 12-week retention period only the training effects of HDL-C (P < 0.05) and VO2max (P < 0.05) remained robust. Additionally, music-synchronised walking was found to reduce the fat ratio (P = 0.031), while paced walking was found to reduce body mass (P = 0.049). CONCLUSIONS The significant pre-post changes in health-related outcomes across the 24-week walking intervention, including improved blood composition, longer step length, and better cardiorespiratory capacity, show that this intervention is promising for improving health and fitness. When, during the retention period, the participants resumed their usual lifestyles without supervised exercise, most physiological biomarkers deteriorated. Thus, for sedentary middle-aged females, persistent behavioural change is necessary to retain the health benefits of physical exercise.
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Affiliation(s)
- Yi Wang
- grid.24539.390000 0004 0368 8103Department of Physical Education, Renmin University of China, Beijing, China ,grid.24539.390000 0004 0368 8103Sports and Social Development Research Center, Renmin University of China, Beijing, China
| | - Xian Guo
- grid.411614.70000 0001 2223 5394Sport Science School, Beijing Sport University, Beijing, China
| | - Hongchu Wang
- grid.263785.d0000 0004 0368 7397School of Mathematical Sciences, South China Normal University, Guangzhou, China
| | - Yinru Chen
- grid.411614.70000 0001 2223 5394College of Education, Beijing Sport University, Beijing, China
| | - Naxin Xu
- grid.411614.70000 0001 2223 5394Sport Science School, Beijing Sport University, Beijing, China
| | - Minghao Xie
- National Institute of Sports Medicine, Beijing, China
| | - Duo Wai-Chi Wong
- grid.16890.360000 0004 1764 6123Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hung Hom Hong Kong, China ,grid.16890.360000 0004 1764 6123Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hung Hom Hong Kong, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Shatin Hong Kong, China
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Lai DKH, Zha LW, Leung TYN, Tam AYC, So BPH, Lim HJ, Cheung DSK, Wong DWC, Cheung JCW. Dual ultra-wideband (UWB) radar-based sleep posture recognition system: Towards ubiquitous sleep monitoring. Engineered Regeneration 2022. [DOI: 10.1016/j.engreg.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Tam AYC, Zha LW, So BPH, Lai DKH, Mao YJ, Lim HJ, Wong DWC, Cheung JCW. Depth-Camera-Based Under-Blanket Sleep Posture Classification Using Anatomical Landmark-Guided Deep Learning Model. Int J Environ Res Public Health 2022; 19:13491. [PMID: 36294072 PMCID: PMC9603239 DOI: 10.3390/ijerph192013491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/11/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Emerging sleep health technologies will have an impact on monitoring patients with sleep disorders. This study proposes a new deep learning model architecture that improves the under-blanket sleep posture classification accuracy by leveraging the anatomical landmark feature through an attention strategy. The system used an integrated visible light and depth camera. Deep learning models (ResNet-34, EfficientNet B4, and ECA-Net50) were trained using depth images. We compared the models with and without an anatomical landmark coordinate input generated with an open-source pose estimation model using visible image data. We recruited 120 participants to perform seven major sleep postures, namely, the supine posture, prone postures with the head turned left and right, left- and right-sided log postures, and left- and right-sided fetal postures under four blanket conditions, including no blanket, thin, medium, and thick. A data augmentation technique was applied to the blanket conditions. The data were sliced at an 8:2 training-to-testing ratio. The results showed that ECA-Net50 produced the best classification results. Incorporating the anatomical landmark features increased the F1 score of ECA-Net50 from 87.4% to 92.2%. Our findings also suggested that the classification performances of deep learning models guided with features of anatomical landmarks were less affected by the interference of blanket conditions.
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Affiliation(s)
- Andy Yiu-Chau Tam
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Li-Wen Zha
- Department of Bioengineering, Imperial College, London SW7 2AZ, UK
| | - Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Hyo-Jung Lim
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China
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Hong TTH, Wang Y, Wong DWC, Zhang G, Tan Q, Chen TLW, Zhang M. The Influence of Mattress Stiffness on Spinal Curvature and Intervertebral Disc Stress-An Experimental and Computational Study. Biology (Basel) 2022; 11:1030. [PMID: 36101411 PMCID: PMC9311775 DOI: 10.3390/biology11071030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Sleeping support systems can influence spinal curvature, and the misalignment of the spinal curvature can lead to musculoskeletal problems. Previous sleep studies on craniocervical support focused on pillow variants, but the mattress supporting the pillow has rarely been considered. This study used a cervical pillow and three mattresses of different stiffnesses, namely soft, medium, and hard, with an indentation load deflection of 20, 42, and 120 lbs, respectively. A novel electronic curvature measurement device was adopted to measure the spinal curvature, whereby the intervertebral disc loading was computed using the finite element method. Compared with the medium mattress, the head distance increased by 30.5 ± 15.9 mm, the cervical lordosis distance increased by 26.7 ± 14.9 mm, and intervertebral disc peak loading increased by 49% in the soft mattress environment. Considering that the pillow support may increase when using a soft mattress, a softer or thinner pillow is recommended. The head distance and cervical lordosis distance in the hard mattress environment were close to the medium mattress, but the lumbar lordosis distance reduced by 10.6 ± 6.8 mm. However, no significant increase in intervertebral disc loading was observed, but contact pressure increased significantly, which could cause discomfort and health problems.
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Affiliation(s)
- Tommy Tung-Ho Hong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
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Lam WK, Liu RT, Chen B, Huang XZ, Yi J, Wong DWC. Health Risks and Musculoskeletal Problems of Elite Mobile Esports Players: a Cross-Sectional Descriptive Study. Sports Med Open 2022; 8:65. [PMID: 35553264 PMCID: PMC9106768 DOI: 10.1186/s40798-022-00458-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Mobile-gaming athletes sit in the same posture for prolonged periods, contributing to significant health risks. This study investigated the health profiles, fatigue, pain and complaints, and musculoskeletal problems of full-time mobile-gaming athletes. METHODS A total of 50 elite mobile-gaming athletes were involved in this study. They were the starting lineup players from all ten professional teams competing in a top-tier multiplayer online battle arena tournament. A survey was conducted to evaluate their fatigue patterns, pain levels, and complaints. A descriptive analysis was conducted to evaluate the athletes' health profiles [body mass index (BMI), fat ratio], fatigue, number of complaints, and musculoskeletal problems. The associations of career duration with BMI, fat ratio, and the total number of confirmed injuries were then determined using Spearman's rank correlation test. RESULTS A total of 46% and 44% of the participants felt tired frequently and occasionally, while 34% and 58% experienced eyestrain frequently and occasionally, respectively. More than 30% of the participants reported headache and rhinitis. A longer esports career duration was associated with a reduction in BMI (r = -0.272, p = 0.056). Career duration had no significant association with smoking habits (p = 0.666), alcohol habits (p = 0.655), coffee habits (p = 0.946), rounds of games for which the player could maintain concentration (p = 0.253), ease of eyestrain (p = 0.569), tiredness (p = 0.510), dizziness (p = 0.071), or leg numbness (p = 0.318). CONCLUSION The findings of this study stress the significance of esports injuries and indicate preventive measures for both athletes and recreational players.
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Affiliation(s)
- Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong, China.
| | - Rui-Tan Liu
- Dr. Chen Sport Training and Rehabilitation Research Center, Beijing, 101111, China
| | - Bob Chen
- Dr. Chen Sport Training and Rehabilitation Research Center, Beijing, 101111, China
| | - Xin-Zhou Huang
- Dr. Chen Sport Training and Rehabilitation Research Center, Beijing, 101111, China
| | - Jie Yi
- Dr. Chen Sport Training and Rehabilitation Research Center, Beijing, 101111, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, 999077, China.
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Lam WK, Chen B, Liu RT, Cheung JCW, Wong DWC. Spine Posture, Mobility, and Stability of Top Mobile Esports Athletes: A Case Series. Biology (Basel) 2022; 11:biology11050737. [PMID: 35625465 PMCID: PMC9138953 DOI: 10.3390/biology11050737] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022]
Abstract
Professional esports athletes spend a long time in the same sitting posture during training and competition. Mobile esports may exacerbate potential postural problems because of the closer and unsupported arms and because athletes spend more time in a forward-/flexed-head posture. Prolonged sitting in these postures carries significant health risks and may lead to musculoskeletal problems and injuries. The objective of this retrospective study is to assess the posture, mobility, and stability of the spine for professional mobile esports athletes. We collected spine-assessment data from 48 athletes participating in a top-tier league on a real-time-strategy battle-arena online game. The spinal assessment was conducted using the SpinalMouse® under upright standing and trunk flexion in addition to the Matthiass test. Measurements were converted into Idiag Scores by the SpinalMouse® software. The Idiag Posture, Idiag Mobility, and Idiag Stability scores were 62.50 (IQR: 21), 63.50 (IQR: 19.5), and 54.50 (IQR: 14.5), respectively, and were significantly lower (p < 0.001) than the reference normative value (100). Age was found to have a weak positive correlation with the posture score (ρ = 0.29, p = 0.048). Although career duration appeared to lower the scores, the association was insignificant (p > 0.05). The scores also had no significant association with body height, body mass, body mass index, and esports team (p > 0.05). It was anticipated that mobile-based esports would attenuate the biomechanics of the spine and increase the likelihood of musculoskeletal problems, such as neck and back pain.
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Affiliation(s)
- Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong 999077, China;
| | - Bob Chen
- Dr Chen Sport Training and Rehabilitation Research Center, Beijing 101111, China;
- Correspondence: (B.C.); (D.W.-C.W.); Tel.: +86-137-0106-6063 (B.C.); +852-2766-7669 (D.W.-C.W.)
| | - Rui-Tan Liu
- Dr Chen Sport Training and Rehabilitation Research Center, Beijing 101111, China;
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Correspondence: (B.C.); (D.W.-C.W.); Tel.: +86-137-0106-6063 (B.C.); +852-2766-7669 (D.W.-C.W.)
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So BPH, Lai DKH, Cheung DSK, Lam WK, Cheung JCW, Wong DWC. Virtual Reality-Based Immersive Rehabilitation for Cognitive- and Behavioral-Impairment-Related Eating Disorders: A VREHAB Framework Scoping Review. Int J Environ Res Public Health 2022; 19:ijerph19105821. [PMID: 35627357 PMCID: PMC9141870 DOI: 10.3390/ijerph19105821] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022]
Abstract
Virtual reality (VR) technology is one of the promising directions for rehabilitation, especially cognitive rehabilitation. Previous studies demonstrated successful rehabilitation in motor, cognitive, and sensorial functions using VR. The objective of this review is to summarize the current designs and evidence on immersive rehabilitation interventions using VR on cognitive- or behavioral-related eating disorders, which was mapped using a VREHAB framework. Two authors independently searched electronic databases, including PubMed, Web of Science, Scopus, CINAHL, EMBASE, and Cochrane Library. Ten (n = 10) articles were eligible for review. Treatments for anorexia nervosa and binge eating disorder/bulimia nervosa were reported through enhanced/experimental cognitive behavior therapy (ECT), cue exposure therapy (CET), and body exposure therapy (BET) via the virtual environment. Some studies reported that the VR effects were superior or comparable to traditional treatments, while the effects may last longer using VR technology. In addition, VR was perceived as acceptable and feasible among patients and therapists and could be valuable for supplementing existing therapies, relieving manpower and caregiver burdens. Future studies may consider incorporating haptic, smell, and biofeedback to improve the experience, and thus the effects of the treatments for the users.
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Affiliation(s)
- Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Derek Ka-Hei Lai
- Department of Computing, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Daphne Sze-Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong 999077, China;
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Correspondence: (J.C.-W.C.); (D.W.-C.W.); Tel.: +852-2766-7673 (J.C.-W.C.); +852-2766-7669 (D.W.-C.W.)
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Correspondence: (J.C.-W.C.); (D.W.-C.W.); Tel.: +852-2766-7673 (J.C.-W.C.); +852-2766-7669 (D.W.-C.W.)
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Peng Y, Wang Y, Wong DWC, Chen TLW, Chen SF, Zhang G, Tan Q, Zhang M. Different Design Feature Combinations of Flatfoot Orthosis on Plantar Fascia Strain and Plantar Pressure: A Muscle-Driven Finite Element Analysis With Taguchi Method. Front Bioeng Biotechnol 2022; 10:853085. [PMID: 35360398 PMCID: PMC8960448 DOI: 10.3389/fbioe.2022.853085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/18/2022] [Indexed: 11/23/2022] Open
Abstract
Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. A flatfoot-orthosis finite element model was constructed by considering the three-dimensional geometry of plantar fascia. The plantar fascia model accounted for the interaction with the bulk soft tissue. The Taguchi approach was adopted to analyze the significance of four design factors combination (arch support height, medial posting inclination, heel cup height, and material stiffness). Predicted plantar pressure and plantar fascia strains in different design combinations at the midstance instant were reported. The results indicated that the foot orthosis with higher arch support (45.7%) and medial inclination angle (25.5%) effectively reduced peak plantar pressure. For the proximal plantar fascia strain, arch support (41.8%) and material stiffness (37%) were strong influencing factors. Specifically, higher arch support and softer material decreased the peak plantar fascia strain. The plantar pressure and plantar fascia loading were sensitive to the arch support feature. The proposed statistics-based finite element flatfoot model could assist the insole optimization and evaluation for individuals with flatfoot.
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Affiliation(s)
- Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Shane Fei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- *Correspondence: Ming Zhang,
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Lv ML, Ni M, Sun W, Wong DWC, Zhou S, Jia Y, Zhang M. Biomechanical Analysis of a Novel Double-Point Fixation Method for Displaced Intra-Articular Calcaneal Fractures. Front Bioeng Biotechnol 2022; 10:791554. [PMID: 35356772 PMCID: PMC8959616 DOI: 10.3389/fbioe.2022.791554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
The development of minimally invasive procedures and implant materials has improved the fixation strength of implants and is less traumatic in surgery. The purpose of this study was to propose a novel “double-point fixation” for calcaneal fractures and compare its biomechanical stability with the traditional “three-point fixation.” A three-dimensional finite element foot model with a Sanders type IIIAB calcaneal fracture was developed based on clinical images comprising bones, plantar fascia, ligaments, and encapsulated soft tissue. Double-point and three-point fixation resembled the surgical procedure with a volar distal radius plate and calcaneal locking plate, respectively. The stress distribution, fracture displacement, and change of the Böhler angle and Gissane’s angle were estimated by a walking simulation using the model, and the predictions between the double-point and three-point fixation were compared at heel-strike, midstance, and push-off instants. Double-point fixation demonstrated lower bone stress (103.3 vs. 199.4 MPa), but higher implant stress (1,084.0 vs. 577.9 MPa). The model displacement of double-point fixation was higher than that of three-point fixation (3.68 vs. 2.53 mm). The displacement of the posterior joint facet (0.127 vs. 0.150 mm) and the changes of the Böhler angle (0.9° vs. 1.4°) and Gissane’s angle (0.7° vs. 0.9°) in double-point fixation were comparably lower. Double-point fixation by volar distal radius plates demonstrated sufficient and favorable fixation stability and a lower risk of postoperative stress fracture, which may potentially serve as a new fixation modality for the treatment of displaced intra-articular calcaneal fractures.
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Affiliation(s)
- Miko Lin Lv
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Ming Ni
- Department of Orthopedics, Pudong New Area People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Wanju Sun
- Department of Orthopedics, Pudong New Area People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Shuren Zhou
- School of Computer and Communication Engineering, Changsha University of Science and Technology, Changsha, China
| | - Yongwei Jia
- Department of Spine Surgery, Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Yongwei Jia,
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Lin-Wei Chen T, Wai-Chi Wong D, Peng Y, Wang Y, Kwan-Kei Wong I, Lam TK, Lam WK, Zhang M. The interaction effects of rocker angle and apex location in rocker shoe design on foot biomechanics and Achilles tendon loading. Medicine in Novel Technology and Devices 2022. [DOI: 10.1016/j.medntd.2021.100111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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25
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Chen TLW, Wong DWC, Wang Y, Tan Q, Lam WK, Zhang M. Changes in segment coordination variability and the impacts of the lower limb across running mileages in half marathons: Implications for running injuries. J Sport Health Sci 2022; 11:67-74. [PMID: 32992036 PMCID: PMC8848018 DOI: 10.1016/j.jshs.2020.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/18/2020] [Accepted: 08/10/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND Segment coordination variability (CV) is a movement pattern associated with running-related injuries. It can also be adversely affected by a prolonged run. However, research on this topic is currently limited. The purpose of this study was to investigate the effects of a prolonged run on segment CV and vertical loading rates during a treadmill half marathon. METHODS Fifteen healthy runners ran a half marathon on an instrumental treadmill in a biomechanical laboratory. Synchronized kinematic and kinetic data were collected every 2 km (from 2 km until 20 km), and the data were processed by musculoskeletal modeling. Segment CVs were computed from the angle-angle plots of selected pelvis-thigh, thigh-shank, and shank-rearfoot couplings using a modified vector coding technique. The loading rate of vertical ground reaction force was also calculated. A one-way MANOVA with repeated measures was performed on each of the outcome variables to examine the main effect of running mileage. RESULTS Significant effects of running mileage were found on segment CVs (p ≤ 0.010) but not on loading rate (p = 0.881). Notably, during the early stance phase, the CV of pelvis frontal vs. thigh frontal was significantly increased at 20 km compared with the CV at 8 km (g = 0.59, p = 0.022). The CV of shank transverse vs. rearfoot frontal decreased from 2 km to 8 km (g = 0.30, p = 0.020) but then significantly increased at both 18 km (g = 0.05, p < 0.001) and 20 km (g = 0.36, p < 0.001). CONCLUSION At the early stance, runners maintained stable CVs on the sagittal plane, which could explain the unchanged loading rate throughout the half marathon. However, increased CVs on the frontal/transverse plane may be an early sign of fatigue and indicative of possible injury risk. Further studies are necessary for conclusive statements in this regard.
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Affiliation(s)
- Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Co. Ltd, Beijing 101111, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Wing-Kai Lam
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Co. Ltd, Beijing 101111, China; Department of Kinesiology, Shenyang Sports Institute, Shenyang 110102, China.
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China.
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26
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Cheung JCW, So BPH, Ho KHM, Wong DWC, Lam AHF, Cheung DSK. Wrist accelerometry for monitoring dementia agitation behaviour in clinical settings: A scoping review. Front Psychiatry 2022; 13:913213. [PMID: 36186887 PMCID: PMC9523077 DOI: 10.3389/fpsyt.2022.913213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Agitated behaviour among elderly people with dementia is a challenge in clinical management. Wrist accelerometry could be a versatile tool for making objective, quantitative, and long-term assessments. The objective of this review was to summarise the clinical application of wrist accelerometry to agitation assessments and ways of analysing the data. Two authors independently searched the electronic databases CINAHL, PubMed, PsycInfo, EMBASE, and Web of Science. Nine (n = 9) articles were eligible for a review. Our review found a significant association between the activity levels (frequency and entropy) measured by accelerometers and the benchmark instrument of agitated behaviour. However, the performance of wrist accelerometry in identifying the occurrence of agitation episodes was unsatisfactory. Elderly people with dementia have also been monitored in existing studies by investigating the at-risk time for their agitation episodes (daytime and evening). Consideration may be given in future studies on wrist accelerometry to unifying the parameters of interest and the cut-off and measurement periods, and to using a sampling window to standardise the protocol for assessing agitated behaviour through wrist accelerometry.
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Affiliation(s)
- James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Ken Hok Man Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Alan Hiu-Fung Lam
- Department of Electrical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Daphne Sze Ki Cheung
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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27
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Peng Y, Niu W, Wong DWC, Wang Y, Chen TLW, Zhang G, Tan Q, Zhang M. Biomechanical comparison among five mid/hindfoot arthrodeses procedures in treating flatfoot using a musculoskeletal multibody driven finite element model. Comput Methods Programs Biomed 2021; 211:106408. [PMID: 34537493 DOI: 10.1016/j.cmpb.2021.106408] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Mid/hindfoot arthrodesis could modify the misalignment of adult-acquired flatfoot and attenuate pain. However, the long-term biomechanical effects of these surgical procedures remain unclear, and the quantitative evidence is scarce. Therefore, we aimed to investigate and quantify the influences of five mid/hindfoot arthrodeses on the internal foot biomechanics during walking stance. METHODS A young participant with flexible flatfoot was recruited for this study. We reconstructed a subject-specific musculoskeletal multibody driven-finite element (FE) foot model based on the foot magnetic resonance imaging. The severe flatfoot model was developed from the flexible flatfoot through the attenuation of ligaments and the unloading of the posterior tibial muscle. The five mid/hindfoot arthrodeses simulations (subtalar, talonavicular, calcaneocuboid, double, and triple arthrodeses) and a control condition (no arthrodesis) were performed simultaneously in the detailed foot multibody dynamics model and FE model. Muscle forces calculated by a detailed multi-segment foot model and ground reaction force were used to drive the foot FE model. The internal foot loadings were compared among control and these arthrodeses conditions at the first and second vertical ground reaction force (VGRF) peak and VGRF valley instants. RESULTS The results indicated that the navicular heights in double and triple arthrodeses were higher than other surgical procedures, while the subtalar arthrodesis had the smallest values. Five mid/hindfoot arthrodeses reduced the peak plantar fascia stress compared to control. However, double and triple arthrodeses increased the peak medial cuneo-navicular joint contact pressures and peak foot pressures as well as the metatarsal bones stresses. CONCLUSION Although mid/hindfoot arthrodesis generally reduced the collapse of medial longitudinal arch and plantar fascia loading during the stance phase, the increased loading in the adjacent unfused joint and metatarsal bones for double and triple arthrodeses should be noted. These findings could account for some symptoms experienced by flatfoot patients after surgery, which may facilitate the optimization of surgical protocols.
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Affiliation(s)
- Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Wenxin Niu
- Shanghai Yangzhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai 201619, China; Clinical Center for Intelligent Rehabilitation Research, Tongji University, Shanghai 201619, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong SAR 999077, China; Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China.
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Cheng KW, Peng Y, Chen TLW, Zhang G, Cheung JCW, Lam WK, Wong DWC, Zhang M. A Three-Dimensional Printed Foot Orthosis for Flexible Flatfoot: An Exploratory Biomechanical Study on Arch Support Reinforcement and Undercut. Materials (Basel) 2021; 14:5297. [PMID: 34576526 PMCID: PMC8469370 DOI: 10.3390/ma14185297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 11/18/2022]
Abstract
The advancement of 3D printing and scanning technology enables the digitalization and customization of foot orthosis with better accuracy. However, customized insoles require rectification to direct control and/or correct foot deformity, particularly flatfoot. In this exploratory study, we aimed at two design rectification features (arch stiffness and arch height) using three sets of customized 3D-printed arch support insoles (R+U+, R+U-, and R-U+). The arch support stiffness could be with or without reinforcement (R+/-) and the arch height may or may not have an additional elevation, undercutting (U+/-), which were compared to the control (no insole). Ten collegiate participants (four males and six females) with flexible flatfoot were recruited for gait analysis on foot kinematics, vertical ground reaction force, and plantar pressure parameters. A randomized crossover trial was conducted on the four conditions and analyzed using the Friedman test with pairwise Wilcoxon signed-rank test. Compared to the control, there were significant increases in peak ankle dorsiflexion and peak pressure at the medial midfoot region, accompanied by a significant reduction in peak pressure at the hindfoot region for the insole conditions. In addition, the insoles tended to control hindfoot eversion and forefoot abduction though the effects were not significant. An insole with stronger support features (R+U+) did not necessarily produce more favorable outcomes, probably due to over-cutting or impingement. The outcome of this study provides additional data to assist the design rectification process. Future studies should consider a larger sample size with stratified flatfoot features and covariating ankle flexibility while incorporating more design features, particularly medial insole postings.
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Affiliation(s)
- Ka-Wing Cheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
| | - Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou 510000, China;
- Department of Kinesiology, Shenyang Sport University, Shenyang 110102, China
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing 101111, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-W.C.); (Y.P.); (T.L.-W.C.); (G.Z.); (J.C.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
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Wong DWC, Chen TLW, Peng Y, Lam WK, Wang Y, Ni M, Niu W, Zhang M. An instrument for methodological quality assessment of single-subject finite element analysis used in computational orthopaedics. Medicine in Novel Technology and Devices 2021. [DOI: 10.1016/j.medntd.2021.100067] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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30
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Zheng L, Wong DWC, Chen X, Chen Y, Li P. Risk of proximal femoral nail antirotation (PFNA) implant failure upon different lateral femoral wall thickness in intertrochanteric fracture: a finite element analysis. Comput Methods Biomech Biomed Engin 2021; 25:512-520. [PMID: 34378469 DOI: 10.1080/10255842.2021.1964488] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Proximal Femoral Nail Antirotation (PFNA) has been commonly used to treat intertrochanteric fractures, despite the risk of implant failure. The integrity of the femur could influence the risk of implant failure. This study evaluated the influence of lateral femoral wall thickness on the potential of implant failure. A finite element model of the hip was reconstructed from the Computed Tomography of a female patient. Five intertrochanteric fracture models at different lateral femoral wall thickness (T1 = 27.6 mm, T2 = 25.4 mm, T3 = 23.4 mm, T4 = 21.4 mm, and T5 = 19.3 mm) were then created and fixed with PFNA. We simulated a critical loading condition by a high loading case during walking. Elastoplastic material models with yield stress and failure strain were applied to the bone and implant in which breakage can be simulated using the element deletion function. In addition, the stress and displacement of the implant and femur were analysed. Implant breakage occurred at the sides of the proximal nail canal in cases of T4 and T5 which was further supported by the higher maximum von Mises stress and nail displacement. The increased stress and displacement of the implant may implicate a reduction of stability and risk of implant failure. We suggested that precaution shall be taken when the wall thickness was less than 21.4 mm.
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Affiliation(s)
- Liqin Zheng
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Duo Wai-Chi Wong
- Faculty of Engineering, Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xinmin Chen
- Zhongxiang People's Hospital, Zhongxiang Hospital of Renmin of Wuhan University, Zhongxiang, China
| | - Yuanzhuang Chen
- Department of Orthopaedic, Jiangmen Central Hospital, Affiliated Jiangman Hospital of Sun Yat-Sen University, Jiangmen, China
| | - Pengfei Li
- Department of Orthopaedic, Jiangmen Central Hospital, Affiliated Jiangman Hospital of Sun Yat-Sen University, Jiangmen, China.,Jiangmen Center for Disease Control and Prevention, Jiangmen, China
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31
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Peng Y, Wang Y, Wong DWC, Chen TLW, Zhang G, Tan Q, Zhang M. Extrinsic foot muscle forces and joint contact forces in flexible flatfoot adult with foot orthosis: A parametric study of tibialis posterior muscle weakness. Gait Posture 2021; 88:54-59. [PMID: 33991769 DOI: 10.1016/j.gaitpost.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/11/2021] [Accepted: 05/06/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The posterior tibialis tendon dysfunction (PTTD) is typically associated with progressive flatfoot deformity, which could be alleviated with foot orthosis. However, the evaluation of tibialis posterior (TP) weakness on lower limb mechanics of flatfoot adults with foot orthoses is scarce and requires further investigation. RESEARCH QUESTION This study aimed to examine the effects of TP weakness on lower limb mechanics in flatfoot adults with foot orthosis through gait analysis and musculoskeletal modelling. METHODS Fifteen young adults with flatfoot were recruited from University to perform a gait experiment with and without foot orthoses. Data collected from the motion capture system were used to drive the musculoskeletal modelling for the estimation of the joint force and extrinsic muscle forces of the lower limb. A parametric analysis was conducted by adjusting the TP muscle strength from 40 % to 100 %. Two-way repeated measures ANOVA was used to compare the peak extrinsic foot muscle forces and joint forces among different levels of TP weakness and insole conditions. RESULTS TP weakness significantly increased ankle joint force superoinferiorly (F = 125.9, p < 0.001) and decreased anteroposteriorly (F = 125.9, p < 0.001), in addition to a significant increase in the muscle forces of flexor hallucis longus (p < 0.001) and flexor digitorum longus (p < 0.001). Besides, the foot orthosis significantly reduced most peak muscle forces whilst significantly reduced the second peak knee force and peak ankle force compared to the control condition (F = 8.79-30.9, p < 0.05). SIGNIFICANCE The increased extrinsic foot muscle forces (flexor hallucis longus and flexor digitorum longus) and ankle joint forces in the TP weakness condition indicated that TP weakness may induce compensatory muscle activation and attenuated joint load. The abnormal muscle and joint mechanics in flatfoot adults with TP weakness might be restored by the orthosis.
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Affiliation(s)
- Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.
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Chen TLW, Lam WK, Wong DWC, Zhang M. A half marathon shifts the mediolateral force distribution at the tibiofemoral joint. Eur J Sport Sci 2021; 22:1017-1024. [PMID: 34077303 DOI: 10.1080/17461391.2021.1938690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Runners' gait patterns vary during a half marathon and influence the knee joint mechanics. Joint contact force is a better estimate of the net joint loadings than external joint moments and closely correlates to injury risks. This study explored the changes of lower limb joint kinematics, muscle activities, and knee joint loading in runners across the running mileages of a half marathon. Fourteen runners completed a half marathon on an instrumented treadmill where motion capture was conducted every 2 km (from 2 to 20 km). A musculoskeletal model incorporating medial/lateral tibiofemoral compartments was used to process the movement data and report outcome variables at the selected distance checkpoints. Statistics showed no changes in joint angles, muscle co-contraction index, ground reaction force variables, and medial tibiofemoral contact force (p > 0.05). Knee adduction moment at 18 km was significantly lower than those at 2 km (p = 0.002, γ = 0.813) and 6 km (p = 0.001, γ = 0.663). Compared to that at 2 km, lateral tibiofemoral contact force was reduced at 18 km (p = 0.030, Hedges' g = 0.690), 16 km (p < 0.001, Hedges' g = 0.782), 14 km (p = 0.045, Hedges' g = 0.859), and 10 km (p < 0.001, Hedges' g = 0.771) respectively. Mechanical realignment of the lower limb may be the cause of the altered knee loadings and possibly led to reduced running economy in response to a prolonged run. The injury potential of the redistributed tibiofemoral forces warranted further studies.
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Affiliation(s)
- Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China.,Li Ning Sports Technology (Shenzhen) Co. Ltd., Shenzhen, People's Republic of China
| | - Wing-Kai Lam
- Li Ning Sports Technology (Shenzhen) Co. Ltd., Shenzhen, People's Republic of China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Co. Ltd., Beijing, People's Republic of China.,Department of Kinesiology, Shenyang Sports Institute, Shenyang, People's Republic of China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China.,Department of Kinesiology, Shenyang Sports Institute, Shenyang, People's Republic of China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China.,Department of Kinesiology, Shenyang Sports Institute, Shenyang, People's Republic of China
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Peng Y, Wong DWC, Chen TLW, Wang Y, Zhang G, Yan F, Zhang M. Influence of arch support heights on the internal foot mechanics of flatfoot during walking: A muscle-driven finite element analysis. Comput Biol Med 2021; 132:104355. [PMID: 33812264 DOI: 10.1016/j.compbiomed.2021.104355] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/05/2021] [Accepted: 03/20/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Different arch support heights of the customized foot orthosis could produce different effects on the internal biomechanics of the foot. However, quantitative evidence is scarce. Therefore, we aimed to investigate and quantify the influence of arch support heights on the internal foot biomechanics during walking stance. METHODS We reconstructed a foot finite element model from a volunteer with flexible flatfoot. The model enabled a three-dimensional representation of the plantar fascia and its interactions with surrounding osteotendinous structures. The volunteer walked in foot orthosis with different arch heights (low, neutral, and high). Muscle forces during gaits were calculated by a multibody model and used to drive a foot finite element model. The foot contact pressures and plantar fascia strains in different regions were compared among the insole conditions at the first and second vertical ground reaction force (VGRF) peak and VGRF valley instants. RESULTS The results indicated that peak foot pressures decreased in balanced standing and second VGRF as the arch support height increased. However, peak midfoot pressures increased during all simulated instants. Meanwhile, high arch support decreased the plantar fascia loading by 5%-15.4% in proximal regions but increased in the middle and distal regions. CONCLUSION Although arch support could generally decrease the plantar foot pressure and plantar fascia loading, the excessive arch height may induce high midfoot pressure and loadings at the central portion of the plantar fascia. The consideration of fascia-soft tissue interaction in modeling could improve the prediction of plantar fascia strains towards design optimization for orthoses.
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Affiliation(s)
- Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Fei Yan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.
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Abstract
Background Intra-articular calcaneal fracture remains challenging to manage. Computed tomography and fracture mapping are useful for the diagnosis and treatment of calcaneal fractures. The aim of the present study was to characterize calcaneal fracture patterns using fracture mapping. Methods Sixty-two calcaneal fractures were retrospectively included in the study. For each case, the fracture was simulated reduction manually. The fracture lines and zones of comminution were graphically superimposed onto an intact calcaneal template to identify fracture patterns. Major fracture lines and comminution were assessed by focusing on the posterior joint facet, medial wall, lateral wall, sustentaculum tali, and anterior process. Results The fracture lines were mostly concentrated on the area anterior to the posterior joint facet and extended medially. The longitudinal lines ran posteriorly from the angle of Gissane, and separated the sustentaculum tali and medial wall from the calcaneal tuberosity. In the lateral wall, the fracture lines extended posteriorly with some branches to the bottom of the calcaneus. No fracture lines passed through the sustentaculum tali. Fracture lines of the posterior tuberosity and anterior process were rare. Conclusions Calcaneal fracture lines follow characteristic patterns, which are closely related to the bone structure and fracture mechanism. These fracture patterns will aid clinicians choose surgical approach and fixations in the treatment of calcaneal fractures.
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Affiliation(s)
- Ming Ni
- Department of Orthopaedics, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Miko Lin Lv
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Wanju Sun
- Department of Orthopaedics, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yingqi Zhang
- Department of Orthopaedics, Tongji Hospital of Tongji University, Shanghai, China
| | - Jiong Mei
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Haowei Zhang
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Yongwei Jia
- Department of Spine Surgery, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
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Lv ML, Zhang H, Chen L, Liu Y, Wang F, Wong DWC, Sun L, Ni M. Finite element method based parametric study of Gastrocnemius-soleus recession: implications to the treatment of midfoot-forefoot overload syndrome. Comput Methods Biomech Biomed Engin 2020; 24:913-921. [PMID: 33320018 DOI: 10.1080/10255842.2020.1858817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Gastrocnemius-soleus recession has been used to treat midfoot-forefoot overload syndrome and plantar fasciitis induced by equinus of the ankle joint. A controlled and selective amount of recession is imperative to maintain muscle strength and stability. The objective of this study was to conduct a parametric study to quantify the relationship between the level of recession and plantar fascia stress. A finite element model of the foot-ankle-shank complex was reconstructed from magnetic resonance and computed tomography images of a 63-year-old normal female. The model was validated by comparing modeled stresses to the measured plantar pressure distribution of the model participant during balanced standing. The midstance and push-off instants of walking stance were simulated with different levels and combinations of gastrocnemius-soleus recession resembled by different amounts of muscle forces. Halving the muscle forces at midstance reduced the average plantar fascia stress by a quarter while reducing two-third of the muscle forces at push-off reduced the average fascia stress by 18.2%. While the first ray of the plantar fascia experienced the largest stress among the five fasciae, the stress was reduced by 77.8% and 16.9% when the load was halved and reduced by two-third at midstance and push-off instants, respectively. Reduction in fascia stress implicates a lower risk of plantar fasciitis and other midfoot-forefoot overload syndromes. The outcome of this study can aid physicians to determine the amount of gastrocnemius-soleus recession towards patients with vdifferent levels of plantar fascia overstress. A detailed three-dimensional modelling on the plantar fascia is warranted in future study.
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Affiliation(s)
- Miko Lin Lv
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China.,Department of Mechanical Engineering, University of Houston, Houston, TX, USA
| | - Haowei Zhang
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Liang Chen
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Ying Liu
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Fei Wang
- Department of Mechanical Engineering, University of Houston, Houston, TX, USA
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Li Sun
- Department of Mechanical Engineering, University of Houston, Houston, TX, USA
| | - Ming Ni
- Department of Orthopaedics, Pudong New Area Peoples' Hospital, affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
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Zhang G, Wong IKK, Chen TLW, Hong TTH, Wong DWC, Peng Y, Yan F, Wang Y, Tan Q, Zhang M. Identifying Fatigue Indicators Using Gait Variability Measures: A Longitudinal Study on Elderly Brisk Walking. Sensors (Basel) 2020; 20:s20236983. [PMID: 33297364 PMCID: PMC7730469 DOI: 10.3390/s20236983] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 12/23/2022]
Abstract
Real-time detection of fatigue in the elderly during physical exercises can help identify the stability and thus falling risks which are commonly achieved by the investigation of kinematic parameters. In this study, we aimed to identify the change in gait variability parameters from inertial measurement units (IMU) during a course of 60 min brisk walking which could lay the foundation for the development of fatigue-detecting wearable sensors. Eighteen elderly people were invited to participate in the brisk walking trials for 60 min with a single IMU attached to the posterior heel region of the dominant side. Nine sets of signals, including the accelerations, angular velocities, and rotation angles of the heel in three anatomical axes, were measured and extracted at the three walking times (baseline, 30th min, and 60th min) of the trial for analysis. Sixteen of eighteen participants reported fatigue after walking, and there were significant differences in the median acceleration (p = 0.001), variability of angular velocity (p = 0.025), and range of angle rotation (p = 0.0011), in the medial–lateral direction. In addition, there were also significant differences in the heel pronation angle (p = 0.005) and variability and energy consumption of the angles in the anterior–posterior axis (p = 0.028, p = 0.028), medial–lateral axis (p = 0.014, p = 0.014), and vertical axis (p = 0.002, p < 0.001). Our study demonstrated that a single IMU on the posterior heel of the dominant side can address the variability of kinematics parameters for elderly performing prolonged brisk walking and could serve as an indicator for walking instability, and thus fatigue.
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Affiliation(s)
- Guoxin Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Ivy Kwan-Kei Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Tommy Tung-Ho Hong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
| | - Yinghu Peng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Fei Yan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Yan Wang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
| | - Qitao Tan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
| | - Ming Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (G.Z.); (I.K.-K.W.); (T.L.-W.C.); (T.T.-H.H.); (D.W.-C.W.); (Y.P.); (F.Y.); (Y.W.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
- Correspondence: ; Tel.: +852-2766-4939
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Zhang H, Lv ML, Liu Y, Sun W, Niu W, Wong DWC, Ni M, Zhang M. Biomechanical analysis of minimally invasive crossing screw fixation for calcaneal fractures: Implications to early weight-bearing rehabilitation. Clin Biomech (Bristol, Avon) 2020; 80:105143. [PMID: 32829234 DOI: 10.1016/j.clinbiomech.2020.105143] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/13/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Minimally invasive fixation using crossing screws was believed to produce satisfactory clinical outcome whereas its stability in early weight-bearing remained controversial. This study aimed to analyze the biomechanical stability of minimally invasive fixation during balanced standing and walking stance, and provide evidence for early rehabilitation. METHODS A finite element model of foot-ankle-shank complex was reconstructed based on computed tomography and magnetic resonance images, and validated by plantar pressure of the model participant. A Sanders III calcaneal fracture was created on the model, and then fixed using crossing screws. The predicted stress distribution, fracture displacement, Bohler's angle and Gissane's angle were compared between the intact calcaneus and fracture model with the fixation. FINDINGS Postoperatively, the concentrated stress appeared at the junction of the calcaneus and its surrounding tissues (especially Achilles tendon, plantar fascia and ligaments) during standing and walking stances, and the stress exceeded the yield strength of trabecular bone. The longitudinal screws sustained the highest stresses and concentrated at the tips and the calcaneal tuberosity junction. The displacement of posterior joint facet, Bohler's angle, and Gissane's angle were within the acceptable range either standing or walking after the fixation. INTERPRETATION Early weight-bearing standing and walking after minimally invasive fixation may cause high stress concentration thereby induce calcaneus stress fractures and other complications like plantar fasciitis and heel pain, so it should not be supported. The peri-calcaneus tendons, i.e., Achilles tendon and plantar fascia, play key roles in the stabilization of the calcaneal fracture after operation.
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Affiliation(s)
- Haowei Zhang
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China.
| | - Miko Lin Lv
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Yin Liu
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Wanju Sun
- Department of Orthopaedics, Pudong New Area Peoples' Hospital affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201299, China
| | - Wenxin Niu
- Department of Rehabilitation, Medical College of Tongji University, Shanghai 200092, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, SAR 999077, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Ming Ni
- Department of Orthopaedics, Pudong New Area Peoples' Hospital affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201299, China.
| | - Ming Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, SAR 999077, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
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Xu Z, Yan F, Chen TLW, Zhang M, Wong DWC, Jiang WT, Fan YB. Non-amputated limb muscle coordination of unilateral transfemoral amputees. J Biomech 2020; 115:110155. [PMID: 33326898 DOI: 10.1016/j.jbiomech.2020.110155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022]
Abstract
Unilateral transfemoral amputees rely heavily on non-amputated limb muscles to regulate the prosthetic gait. In this study, we compared the non-amputated limb muscle coordination of eight unilateral transfemoral amputees to eight able-bodied controls. Inverse dynamics approach was conducted via a musculoskeletal model to obtain lower limb joint moments and muscle forces. In addition to the muscle forces at the instants of peak joint moments and the maximum muscle forces, the peak joint moments of the lower limbs were also investigated. The results showed that there were significant differences of muscle forces between the non-amputated limbs and the controls at the instant of peak hip extension moment, although the peak hip extension moments themselves were not significantly different between the two groups. The non-amputated limbs had significantly smaller peak hip flexion moment and peak knee extension moment, with significant differences between the muscle forces of non-amputated limbs and controls at the two instants. There was no significant difference between the muscle forces of the non-amputated limbs and controls at the peak knee flexion moment instant, despite the fact that the non-amputated limbs had significantly higher peak knee flexion moments. In addition, the non-amputated limbs had significantly smaller maximum muscle forces than the controls. These results demonstrate that amputees modify their muscle coordination to adapt to the specific joint requirements of the prosthetic gait. Our findings suggest the possibility of non-amputated limb muscle atrophy due to the decrease in the peak muscle forces during walking.
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Affiliation(s)
- Zhi Xu
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, Sichuan University, Chengdu 611065, China; Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, Hong Kong, China; Institute for Disaster Management and Reconstruction, Sichuan University - The Hong Kong Polytechnic University, Chengdu 610065, China
| | - Fei Yan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, Hong Kong, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China.
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Wen-Tao Jiang
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, Sichuan University, Chengdu 611065, China; Institute for Disaster Management and Reconstruction, Sichuan University - The Hong Kong Polytechnic University, Chengdu 610065, China.
| | - Yu-Bo Fan
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
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Abstract
Background Badminton is a popular sport activity in both recreational and elite levels. A lot of biomechanical studies have investigated badminton lunge, since good lunge performance may increase the chances to win the game. This review summarized the current trends, research methods, and parameters-of-interest concerning lower-extremity biomechanics in badminton lunges. Methodology Databases including Web of Science, Cochrane Library, Scopus, and PubMed were searched from the oldest available date to September 2020. Two independent authors screened all the articles and 20 articles were eligible for further review. The reviewed articles compared the differences among playing levels, footwear designs, and lunge directions/variations, using parameters including ground reaction forces, plantar pressure distribution, kinematics, and kinetics. Results Elite badminton players demonstrated higher impact attenuation capability, more aggressive knee and ankle strategy (higher mechanical moment), and higher medial plantar load than amateur players. Footwear modifications can influence comfort perception and movement mechanics, but it remains inconclusive regarding how these may link with lunging performance. Contradicting findings in kinematics is possibly due to the variations in lunge and instructions. Conclusions Playing levels and shoe designs have significant effects on biomechanics in badminton lunges. Future studies can consider to use an unanticipated testing protocol and realistic movement intensity. They can study the inter-limb coordination as well as the contributions and interactions of intrinsic and extrinsic factors to injury risk. Furthermore, current findings can stimulate further research studying whether some specific footwear materials with structural design could potentially compromise impact attenuation, proprioception, and performance.
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Affiliation(s)
- Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China.,Department of Kinesiology, Shenyang Sport University, Shenyang, China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Winson Chiu-Chun Lee
- School of Mechanical, Materials, Mechatronic & Biomedical Engineering, University of Wollongong, Wollongong, New South Wales, Australia
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Wong DWC, Wang Y, Chen TLW, Yan F, Peng Y, Tan Q, Ni M, Leung AKL, Zhang M. Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion). Front Bioeng Biotechnol 2020; 8:571192. [PMID: 33015022 PMCID: PMC7505935 DOI: 10.3389/fbioe.2020.571192] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the load-bearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.
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Affiliation(s)
- Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Fei Yan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Ni
- Department of Orthopaedics, Pudong New Area Peoples’ Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Aaron Kam-Lun Leung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
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Ni M, Zhang F, Mei J, James Lin CY, M S Gruber S, Niu W, Wai-Chi Wong D, Zhang M. Biomechanical analysis of four augmented fixations of plate osteosynthesis for comminuted mid-shaft clavicle fracture: A finite element approach. Exp Ther Med 2020; 20:2106-2112. [PMID: 32765684 PMCID: PMC7401495 DOI: 10.3892/etm.2020.8898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/10/2020] [Indexed: 11/06/2022] Open
Abstract
Sufficient stabilization of comminuted mid-shaft clavicle fractures via plate fixation is difficult to achieve. Various augmentations, including interfragmentary screws and cerclage wiring, have been adopted to reinforce fixation stability. The present study aimed to assess the biomechanical stability of augmented plate fixations using the finite element method. First, a clavicle fracture model was created from CT data. Fixation was then induced using a locking compressive plate (LCP) with the following four augmentations: i) Double inner cerclage wirings (DICW), ii) double outer cerclage wirings (DOCW), iii) a single interfragmentary screw (SIS) and iv) double interfragmentary screws (DIS). Compressive and bending forces of 100 N were subsequently applied at the acromial region of the clavicle. The stress distribution, displacement and fracture micro-motions of the model were assessed and compared. The DOCW resulted in the highest stress exerted on the LCP, followed by SIS, DICW and DIS. For the clavicle fracture, DICW, DOCW and SIS resulted in high stress levels. However, DIS fixation alone resulted in levels of stress that were below the yield strength of cortical bone. Displacement analysis revealed that DOCW fixation resulted in the greatest degree of displacement and fracture micro-motions, followed by SIS, DICW and DIS. The results indicated that SIS, DIS and DOCW may be used as augmentations of LCP fixation for comminuted mid-shaft clavicle fractures. However, DIS was the recommended augmentation due to it exerting the lowest stress and the highest stability compared with the other fixations. The DICW may be used to aid fracture reduction and plate placement in surgery but should be avoided for permanent fixation.
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Affiliation(s)
- Ming Ni
- Department of Orthopaedics, Pudong New Area Peoples' Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai 201299, P.R. China.,Department of Biomedical Engineering, College of Engineering and Applied Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Fangfang Zhang
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, P.R. China
| | - Jiong Mei
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, P.R. China
| | - Chia-Ying James Lin
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Stacey M S Gruber
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Wenxin Niu
- Research Center of Disabled Rehabilitation Medicine, Yangzhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai 200129, P.R. China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR 999077, P.R. China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong 518057, P.R. China
| | - Ming Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR 999077, P.R. China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong 518057, P.R. China
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Meng Z, Wong DWC, Zhang M, Leung AKL. Analysis of compression/release stabilized transfemoral prosthetic socket by finite element modelling method. Med Eng Phys 2020; 83:123-129. [PMID: 32527518 DOI: 10.1016/j.medengphy.2020.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 05/09/2020] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate the residual limb stress of a transfemoral amputee's Compression/Release Stabilized (CRS) socket by finite elemental modelling. The model was constructed from magnetic resonance images of the left residual limb of a 48-year-old male transfemoral amputee. Two conditions were simulated. In the donning condition, the prosthetic socket under the residual limb moved proximally until it reached the required donned position. The weight-bearing condition was subsequently simulated by applying body weight (800N) at the femoral head while keeping the distal end of the socket fixed. The maximum contact pressure was concentrated at the proximal anterior-medial regions of the residual limb surfaces in both conditions. In the donning condition, the maximum von Mises stress and the maximum contact pressure were 277.7 kPa and 254 kPa respectively. The respective values were 191.9 kPa and 218.5 kPa when body weight was applied. The stress and contact pressure did not exceed the suggested threshold value of pain. Our findings provide important biomechanical information on the CRS socket that may help future design optimization.
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Affiliation(s)
- Zhaojian Meng
- Rehabilitation Research Institute, Guangdong Provincial Work Injury Rehabilitation Center, Guangzhou, China; Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Aaron Kam-Lun Leung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
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Abstract
Joint contact force is the actual force applied on the articular surface that could predict performance and injuries, but rarely reported for badminton sport. The study sought to calculate lower limb joint contact force and decelerative kinematics for badminton forward lunges. Fifteen badminton players performed backhand and forehand forward lunges in random order. The kinematic and kinetic data were input to scale a musculoskeletal model and solve inverse dynamics in the simulations. Outcome variables were compared between lunge conditions using repeated measures MANOVA. Forehand lunge produced higher compressional ankle contact force (p = 0.040, partial η2 = 0.14), faster touchdown hip abduction (p = 0.031, partial η2 = 0.16), and larger horizontal deceleration of the mass centre (p = 0.016, partial η2 = 0.19) and torso (p = 0.031, partial η2 = 0.16) compared to backhand lunge. Despite the statistical significance, we found that the increments of joint loading in forehand lunge were small (<5%) with limited effect size and could be attributed to the larger movement deceleration during braking. These force changes could possess performance merits. However, its linkage to injury risk is unclear and warrants further investigation.
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Affiliation(s)
- Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Co. Ltd., Beijing, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Wing-Kai Lam
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Co. Ltd., Beijing, China.,Department of Kinesiology, Shenyang Sports Institute, Shenyang, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
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Zhang H, Lin Lv M, Yang J, Niu W, Cheung JCW, Sun W, Wong DWC, Ni M. Computational modelling of foot orthosis for midfoot arthritis: a Taguchi approach for design optimization. Acta Bioeng Biomech 2020; 22:75-83. [PMID: 34846024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Evaluation of the internal biomechanics of the foot-and-ankle complex is challenging for the prescription of orthosis particularly for midfoot arthritis patients in which the joint condition is crucial. METHODS Using computational modeling and design optimization techniques, the objective of this study was to compare the biomechanical functions among different combinations of design factors using computer simulation. A finite element foot model was reconstructed from a midfoot arthritis patient. Orthotic designs with 3 levels for each of the 3 design factors (arch height, lateral wedge angle, and insole stiffness) contributed to 9 configurations using a fractional factorial design were tested. RESULTS An increase in peak plantar stress of the midfoot was facilitated by a medium arch height and wedge angle, and stiffest insole material, notwithstanding the combination neither reduced the peak plantar stress of other foot regions nor was consistent with the combination that minimized the stress of the articular cartilage. CONCLUSIONS Insole with high arch (H = 30 mm), low stiffness (E = 1.0 MPa), and medium wedge angle (A = 5°) could minimize the stress of the cartilage at the arthritic joint (primary outcome) and could be beneficial to the patients. Also, insole stiffness predominantly influenced cartilage stress. However, secondary outcomes including the stress of the navicular and medial cuneiform and the regional plantar stress did not produce the same solution. Future studies can consider a patient-specific loading profile to further the investigation on the stabilizing effect and the attenuation of load transfer induced by the insole.
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Affiliation(s)
- Haowei Zhang
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Miko Lin Lv
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Department of Orthopaedics, Shanghai Pudong New Area People's Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Junyan Yang
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Wenxin Niu
- Yangzhi Rehabilitation Hospital, Sunshine Rehabilitation Centre, Tongji University School of Medicine, Shanghai, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wanju Sun
- Department of Orthopaedics, Shanghai Pudong New Area People's Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Ni
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Department of Orthopaedics, Shanghai Pudong New Area People's Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Chen TLW, Wong DWC, Peng Y, Zhang M. Prediction on the plantar fascia strain offload upon Fascia taping and Low-Dye taping during running. J Orthop Translat 2019; 20:113-121. [PMID: 31908942 PMCID: PMC6938939 DOI: 10.1016/j.jot.2019.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/18/2019] [Accepted: 06/24/2019] [Indexed: 11/29/2022] Open
Abstract
Background Taping is commonly prescribed to treat plantar fasciitis for runners by virtue of its alleged ability to offload the plantar fascia and facilitate positive injury prognosis. Our study aimed to investigate how different taping methods could change the loading on the plantar fascia during running using computational simulations. Methods A finite element foot model was modified from a previous version to fit the study's purpose. The model featured twenty bones, bulk soft tissue, foot muscles, ligaments/tendons, and a solid part representing the plantar fascia. A runner performed several running trials under one untaped condition and two taped conditions—Low-Dye taping and Fascia taping, which were implemented by a physiotherapist using the Kinesio tapes. The captured motion data were processed to drive a scaled musculoskeletal model and calculate segmental kinematics, foot muscle force, and joint reaction force. These variables were then input as the boundary/loading conditions for finite element analyses of running. The principal tensile strain on the plantar fascia, subtalar eversion, and navicular height during the stance phase were averaged across five trials of each condition and compared using Friedman's test. Results Maximal subtalar eversion did not differ among conditions (p = 0.449). Fascia taping significantly reduced maximal strains on the fascia band (p = 0.034, Kendall's W = 0.64–0.76) and increased the navicular height (p = 0.013, Kendall's W = 0.84) compared with nontaping. There were no significant differences in all outcome variables between Low-Dye taping and nontaping (p = 0.173–0.618). Conclusion From a mechanical point of view, our study provided quantitative evidence to support the application of taping treatments for overstrained plantar fascia. The untensed fascia band by Fascia taping could be a potential indicator of pain relief for the runners. However, a prospective study targeting the patient population would be needed to address the point. The Translational Potential of this Article The study quantified the loading status of the plantar fascia during running and provided mechanical evidence to support the usage of taping as a mean to reduce fascial strain, thus possibly controlling injury risks for the runners. The results of the study also highlighted the importance of selecting specific taping methods based on individuals' needs.
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Affiliation(s)
- Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
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Ni M, Wong DWC, Niu W, Wang Y, Mei J, Zhang M. Biomechanical comparison of modified Calcanail system with plating fixation in intra-articular calcaneal fracture: A finite element analysis. Med Eng Phys 2019; 70:55-61. [DOI: 10.1016/j.medengphy.2019.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/11/2019] [Accepted: 06/09/2019] [Indexed: 11/16/2022]
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Chen TLW, Agresta CE, Lipps DB, Provenzano SG, Hafer JF, Wong DWC, Zhang M, Zernicke RF. Ultrasound elastographic assessment of plantar fascia in runners using rearfoot strike and forefoot strike. J Biomech 2019; 89:65-71. [DOI: 10.1016/j.jbiomech.2019.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 04/05/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022]
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Wong DWC, Wang Y, Lin J, Tan Q, Chen TLW, Zhang M. Sleeping mattress determinants and evaluation: a biomechanical review and critique. PeerJ 2019; 7:e6364. [PMID: 30701143 PMCID: PMC6348954 DOI: 10.7717/peerj.6364] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/30/2018] [Indexed: 11/20/2022] Open
Abstract
Background Sleeping mattress parameters significantly influence sleeping comfort and health, as reflected by the extensive investigations of sleeping support biomechanics to prevent sleep-related musculoskeletal problems. Methodology Herein, we review the current trends, research methodologies, and determinants of mattress biomechanics research, summarizing evidence published since 2008. In particular, we scrutinize 18 articles dealing with the development of new designs, recommendation criteria, instruments/methods of spine alignment evaluation, and comparative evaluation of different designs. Results The review demonstrated that mattress designs have strived for customization, regional features, and real-time active control to adapt to the biomechanical features of different body builds and postures. However, the suggested threshold or target values for desirable spine alignment and body pressure distribution during sleep cannot yet be justified in view of the lack of sufficient evidence. Conclusions It is necessary to formulate standard objectives and protocols for carrying out mattress evaluation.
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Affiliation(s)
- Duo Wai-Chi Wong
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Yan Wang
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Jin Lin
- Product Development-R&D Life Nurturing Products, Infinitus (China) Company Limited, Guangzhou, China
| | - Qitao Tan
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Tony Lin-Wei Chen
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
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Chen TLW, Wong DWC, Wang Y, Lin J, Zhang M. Foot arch deformation and plantar fascia loading during running with rearfoot strike and forefoot strike: A dynamic finite element analysis. J Biomech 2019; 83:260-272. [DOI: 10.1016/j.jbiomech.2018.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/24/2018] [Accepted: 12/03/2018] [Indexed: 01/22/2023]
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Abstract
BACKGROUND The wearing of socks and insoles may affect the ability of the foot to detect tactile input influencing postural balance. OBJECTIVES The aim of this study was to investigate whether (1) thick socks adversely affected the elderly postural balance and (2) orthopedic insoles could improve the elderly postural balance while wearing thick socks. STUDY DESIGN Repeated-measures study design. METHODS In total, 14 healthy older adults were recruited. A monofilament test was conducted to evaluate foot plantar sensation with and without thick socks. Subjects then performed the Romberg tests under three conditions: (1) barefoot, (2) with socks only, and (3) with both socks and insoles. Postural balance was assessed by measuring the center of pressure movement during standing in each experimental condition. RESULTS Thick socks significantly decreased the monofilament score ( p < 0.001), suggesting reduction in ability to detect external forces. All center of pressure parameters increased significantly while wearing thick socks ( p < 0.017), implying reduction of postural stability. They then decreased significantly with the additional use of insoles ( p < 0.017). CONCLUSION Previous studies have documented the changes in plantar pressure distribution with the use of orthopedic insoles. This study further suggests that such changes in contact mechanics could produce some balance-improving effects, which appears not to have been reported earlier. Clinical relevance Wearing thick socks reduces plantar pressure sensitivity and increases postural sway which may increase risk of falls. Orthopedic insoles and footwear with similar design could potentially be a cost-effective method in maintaining postural balance when wearing thick socks.
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Affiliation(s)
| | - Duo Wai-Chi Wong
- 1 The Hong Kong Polytechnic University, Hung Hom, Hong Kong.,2 China Rehabilitation Research Center, Beijing, China
| | | | - Winson Chiu-Chun Lee
- 3 Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
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