Biomedical subjects

M L Hull

Publications and source records attributed to M L Hull.

At least 91 records · Page 5Linked to original sources

PubMed1995

Elevated defibrillation threshold when right-sided venous access is used for nonthoracotomy implantable defibrillator lead implantation. The Endotak Investigators.

INTRODUCTION: Although myriad factors influence the defibrillation threshold, the relation between the site of transvenous lead entry into the vascular system and the defibrillation threshold has not been reported. This study examines the influence that venous entry site has on defibrillation success for a transvenous implantable cardioverter defibrillator lead with two defibrillating coils. METHODS AND RESULTS: The study population comprised 345 patients. Their mean age was 61 +/- 13 years and, left ventricular ejection fraction was 0.33 +/- 0.13. A left-sided approach was used in 324 (93.9%) of the patients, and a right-sided approach was used in the remaining 21 (6.1%) patients. There was no difference in the gender, age, left ventricular ejection fraction, or underlying cardiac disease in the two groups. For all patients, with a transvenous lead used either alone or with a submuscular or subcutaneous patch, the biphasic defibrillation threshold was 9.9 +/- 4.8 J when a left-sided approach was used, and 14.0 +/- 7.3 J when a right-sided approach was used (P = 0.02). When a transvenous lead was used with a submuscular or subcutaneous patch (115 patients), the biphasic defibrillation threshold was 9.5 +/- 4.3 J when a left-sided approach was used, and 12.0 +/- 10.0 J when a right-sided approach was used (P = 0.98). When a transvenous lead was used without a submuscular or subcutaneous patch (230 patients), the biphasic defibrillation threshold was 10.1 +/- 5.0 J when a left-sided approach was used, and 14.6 +/- 6.6 J when a right-sided approach was used (P < 0.01). For the entire group of patients and for each specific lead arrangement, there was no significant difference in the defibrillating lead system impedance when right-sided versus left-sided approaches were compared. CONCLUSION: Left-sided approaches to implant transvenous leads with two coils for defibrillation result in lower biphasic defibrillation thresholds than when right-sided approaches are used.

Defibrillators, Implantable↗

PubMed1995

A new load application system for in vitro study of ligamentous injuries to the human knee joint.

This paper describes the design and accuracy evaluation of a new six degree of freedom load application system for in vitro testing of the human knee joint. External loads of both polarity in all six degrees of freedom can be applied either individually or in any combination while the knee is permitted to move unconstrained in response to applied loads. The flexion/extension degree of freedom permits the full physiological range of motion. In addition to external loads, forces of the three major muscle groups (quadriceps, hamstrings, gastrocnemius) crossing the joint can be developed. Full automation and rapid convergence of loads to programmed values are achieved through a computer which feeds command signals to servo controller/electro-pneumatic servo values. The servo values regulate pressure to pneumatic actuators which develop the various loads. Experiments undertaken to quantify the accuracy of both load and displacement measurements reveal that errors particularly in load measurement are effectively controlled through the apparatus design.

Anterior Cruciate Ligament↗

PubMed1994

A comparison of muscular mechanical energy expenditure and internal work in cycling.

The hypothesis that the sum of the absolute changes in mechanical energy (internal work) is correlated with the muscular mechanical energy expenditure (MMEE) was tested using two elliptical chainrings, one that reduced and one that increased the internal work (compared to circular). Upper and lower bounds were put on the extra MMEE (work done by net joint torques in excess of the external work) with respect to the effect of intercompensation between joint torques due to biarticular muscles. This was done by having two measures of MMEE, one that allowed no intercompensation and one that allowed complete intercompensation between joints spanned by biarticular muscles. Energy analysis showed no correlation between internal work and the two measures of MMEE. When compared to circular, the chainring that reduced internal work increased MMEE, and phases of increased crank velocity associated with the elliptical shape resulted in increased power absorbed by the upstroke leg as it was accelerated against gravity. The resulting negative work necessitated additional positive work. Thus, the hypothesis that the internal work is correlated with MMEE was found to be invalid, and the total mechanical work done cannot be estimated by summing the internal and external work. Changes in the dynamics of cycling caused by a non-circular chainring may affect performance and must be considered during the non-circular chainring design process.

Absorption↗

PubMed1993

A theoretical basis for interpreting the force applied to the pedal in cycling.

This article presents an analytical technique for decomposing the pedal force in cycling into a muscular component due directly to the net intersegmental moments and a nonmuscular component due to gravitational and inertial effects. The decomposition technique uses the Newton-Euler system of dynamic equations for the leg segments to solve for the two components, given the planar segmental kinematics and the intersegmental moments. Applications of the technique to cycling studies of muscle function, pedalling effectiveness, and optimization analyses based on inverse dynamics are discussed. While this article focuses on the pedal force in cycling, the decomposition method can be directly applied to analyze the reaction forces during a general planar movement of the leg when the segmental kinematics and intersegmental moments are specified. This article also demonstrates the significance of the nonmuscular component relative to the muscular component by performing the decomposition of the pedal forces of an example subject who pedalled at three different cadences against a common work load. The key results were that the nonmuscular components increased in magnitude as the cadence increased, whereas the magnitude of the muscular component remained relatively constant over the majority of the crank cycle. Also, even at the slowest pedalling rate of 70 rpm, the magnitude of the nonmuscular component was substantial.

Acceleration↗

PubMed1993

Response of intersegmental knee loads to foot/pedal platform degrees of freedom in cycling.

The hypothesis tested in this article was that the three-dimensional intersegmental knee loads would be reduced in cycling by foot/pedal platforms which permitted relative motion between the foot and pedal. To test this hypothesis, pedal load and lower limb kinematic data were collected from 11 subjects who pedaled with four foot/pedal platforms mounted on a six-load-component dynamometer. One of the four platforms did not allow any relative foot/pedal movement while the other three permitted either medial/lateral translation, adduction/abduction rotation or inversion/eversion rotation. Three-dimensional intersegmental knee loads were computed for each of the four platforms using a previously reported biomechanical model. A number of quantities describing each of the intersegmental knee load components was computed and compared using analysis of variance techniques. The key results were that the medial/lateral translation platform did not cause significant differences in intersegmental knee load quantities relative to those for the fixed platform. However, both of the platforms permitting rotations significantly reduced many but did not significantly increase any intersegmental knee load quantities. Of these two platforms, the abduction/abduction platform significantly reduced both the axial and varus/valgus knee moments while the inversion/eversion platform significantly reduced only varus/valgus moments. These results have application to bicycle pedal design where the goal is to reduce intersegmental knee loads, hence possibly alleviating overuse knee injuries.

Bicycling↗

PubMed1993

Muscle force as affected by fatigue: mathematical model and experimental verification.

The effects of muscle fatigue have been included in a comprehensive muscle model derivation. The fiber-based muscle model calculates muscle force as the sum of individual fiber forces, determined based on fiber kinematics and activation information. Three fiber types are considered in the model derivation. Fiber force is modified using indices of fatigue which were derived based on the data from experimental work conducted by others. In this paper, derivations of the indices for each of the fiber types are presented. An elbow extension study was performed to validate the modeled fatigue relationship for maximal effort activities. Triceps brachii forces generated during both isometric and dynamic fatigue tests were determined using both the muscle model and a direct approach based on rigid-body dynamics. The forces obtained from the two approaches were not significantly different for times either less than 50 s for the isometric tests, or greater than 40 s for the dynamic tests. Results from the statistical comparison indicate the utility of the modeling approach presented.

Adult↗

PubMed1992

Strain in the anteromedial bundle of the anterior cruciate ligament under combination loading.

Strain within the anteromedial bundle (AMB) of the anterior cruciate ligament (ACL) was measured in 13 human knee specimens in order to determine the combination of external loads most likely to cause injury. Using a load application system that allowed 5 df with the flexion angle being fixed, pure loads of anterior/posterior force, medial/lateral force, varus/valgus torque, and internal/external axial torque were applied at three flexion angles: 0 degrees, 15 degrees, 30 degrees. Combined loads were applied in pairs at two flexion angles: 0 degrees and 30 degrees. Liquid mercury strain gauges were used to measure strain in the ACL. Anterior tibial force was the primary determinant of strain in the anteromedial bundle. This strain was significantly larger at 30 degrees flexion than at 0 degrees. The strain sensitivity of the AMB to medial force was approximately one-half that to pure anterior force. The effect of anterior and medial forces was additive when applied in combination. Neither pure axial torque nor pure varus/valgus torque was observed to strain significantly the AMB at any of the flexion angles investigated. However, valgus torque in combination with anterior force resulted in a significantly larger strain than pure anterior force. Internal axial torque in combination with anterior force also resulted in a larger strain than pure anterior force.

Aged↗

PubMed1992

An activation-recruitment scheme for use in muscle modeling.

The derivation of a new activation-recruitment scheme and the results of a study designed to test its validity are presented. The activation scheme utilizes input data of processed surface EMG signals, muscle composition, muscle architecture, and experimentally determined activation coefficients. In the derivation, the relationship between muscle activation and muscle fiber recruitment was considered. In the experimental study, triceps muscle force was determined for isometric elbow extension tasks varying in intensity from 10 to 100% of a maximum voluntary contraction (MVC) using both a muscle model that incorporates the activation scheme, and inverse dynamics techniques. The forces calculated using the two methods were compared statistically. The modeled triceps force was not significantly different from the experimental results determined using inverse dynamics techniques for average activation levels greater than 25% of MVC, but was significantly different for activation levels less than 25% of MVC. These results lend support for use of the activation-recruitment scheme for moderate to large activation levels, and suggest that factors in addition to fiber recruitment play a role in force regulation at lower activation levels.

Acceleration↗

PubMed1992

The effect of lower-limb anatomy on knee loads during seated cycling.

Overuse knee joint injuries are the primary injuries to cyclists. Overuse injuries have been intuitively linked to the anatomic structure of the foot because external loads are applied to the foot in cycling. Thus, the structure and function of the foot should dictate in part how the loads are transmitted to the knee joint. Therefore, it was hypothesized that patterns in knee loads are related to the anatomic structure of the foot. To test this hypothesis, peak knee loads (dependent variables) were related to anatomical variables (independent variables) through statistical analyses. This required first the detailed evaluation (i.e. measurement) of the anatomical structure of the foot and leg for 23 subjects. Next, three-dimensional knee joint loads were determined for a standardized riding condition. The results of the statistical analyses indicated that a group of cyclists with the most extreme inversion of the forefoot relative to the transverse plane developed significantly greater average posterior knee force and extensive knee moment. In addition, a number of anatomical variables significantly accounted for the variability in peak values of the posterior force, the extensive moment, the varus/valgus moment and the external axial moment. Based on these results, the hypothesis is accepted.

Adult↗

PubMed1992

Three-dimensional knee joint loading during seated cycling.

The hypothesis which motivated the work reported in this article was that neglecting pure moments developed between the foot and pedal during cycling leads to a substantial error in computing axial and varus/valgus moments at the knee. To test this hypothesis, a mathematical procedure was developed for computing the three-dimensional knee loads using three-dimensional pedal forces and moments. In addition to data from a six-load-component pedal dynamometer, the model used pedal position and orientation and knee position in the frontal plane to determine the knee joint loads. Experimental data were collected from the right leg of 11 male subjects during steady-state cycling at 90 rpm and 225 W. The mean peak varus knee moment calculated was 15.3 N m and the mean peak valgus knee moment was 11.2 N m. Neglecting the pedal moment about the anterior/posterior axis resulted in an average absolute error of 2.6 N m and a maximum absolute error of 4.0 N m in the varus/valgus knee moment. The mean peak internal and external axial knee moments were 2.8 N m and 2.3 N m, respectively. The average and maximum absolute errors in the axial knee moment for not including the moment about an axis normal to the pedal were found to be 2.6 N m and 5.0 N m, respectively. The results strongly support the use of three-dimensional pedal loads in the computation of knee joint moments out of the sagittal plane.

Acceleration↗

PubMed1992

Physiological response to cycling with both circular and noncircular chainrings.

The purpose of this study was to compare physiological variables of endurance-trained cyclists riding with four different chainring designs: round, Shimano Biopace, and two engineered ellipse designs. The ellipse designated Eng10 had the crank arm oriented 10 degrees forward of the major (i.e. longer) axis. Eighty degrees further forward, along the minor axis, was the crank arm orientation for the second ellipse, Eng90. With the major to minor axis ratio of 22.9 cm/16.8 cm (1.36), both ellipses imposed a crank angular velocity variation of 27% relative to the highest velocity assuming constant chain velocity. Best described as a skewed ellipse (i.e., major and minor axes not perpendicular), the Biopace had a major to minor axis ratio of 1.09 thus giving a crank angular velocity variation of 8%. Eleven male cyclists rode at a high (80% of maximum VO2) and a low (60% of maximum VO2) workrate using each chainring. The study was conducted over four consecutive days with the presentation order of the chainrings randomized. Open circuit spirometry was used to collect continuous respiratory data. Heart rate, blood lactate, and cadence values also were measured. None of the physiological variables including rates of oxygen consumption showed significant differences among the chainrings. Thus, the gross efficiency of cycling was not improved by any of the noncircular chainrings. For cycling events where efficiency is a determinant of performance, the noncircular chainrings do not offer any advantage over round chainrings.

Adult↗

PubMed1991

A computer simulation of muscle-tendon mechanics.

A computer simulation program was developed to study and illustrate the complex interactions that exist between muscle structure, neural activation, and mechanical characteristics. The software incorporates equations inherent in a comprehensive muscle-tendon model. The software provides a multi-menu interface allowing the user to easily alter quantities related to muscle architecture, kinematics, and activation level. Five different simulations may be performed and graphically displayed including: force-length, force-velocity, force-activation, force-time, and muscle vs tendon length. Up to three different muscle design/contraction condition combinations can be displayed simultaneously for each simulation. Sample simulation results illustrating the mechanical behavior of muscles with different structures are presented.

Biomechanical Phenomena↗

PubMed1991

Apparatus to obtain rotational flexibility of the human knee under moment loads in vivo.

The contributions of this paper are twofold. One is the design and performance evaluation of new equipment to determine the rotational flexibility of the human knee in vivo. Since determining knee flexibility requires the application of external loads and the measurement of knee rotations, the new equipment consists of a load application stand and a triaxial goniometer. The triaxial goniometer noninvasively mounts to the leg and directly measures the relative three degrees-of-freedom rotations of the knee sequentially and independently. The goniometer incorporates several unique design features which enhance measurement accuracy. The load stand applies pure varus/valgus and external/internal axial moments either individually or in combination through the use of motors controlled by the test subject. Unique to this design are features which enable the application of moments to the knee which minimise shear forces. Other unique design features permit the stand to control hip and knee flexion angles, muscle contraction, and axial loading. To assess the accuracy with which rotations are measured during experiments, three tests were conducted with the equipment. One test evaluated the inherent accuracy of the goniometer, a second test assessed the potential for goniometer slippage during loading, and a third explored the effect of goniometer mounting on the repeatability of results. A special verification apparatus facilitated evaluation of goniometer inherent accuracy. A second contribution of the paper is an investigation of the effect of foot constraints (i.e. boundary conditions) on flexibility results. To make this investigation, three subjects were tested with the knee at 15 degrees of flexion. Results revealed large differences in flexibility between constraining the foot in both external/internal and varus/valgus rotations and permitting the foot to rotate freely in the direction not being loaded. Further, constraint moments as high as 23 Nm were also recorded. These results emphasise that in order to obtain accurate flexibility results for isolated loads, the foot must be unconstrained by the loading apparatus.

Biomechanical Phenomena↗

PubMed1991

An angular velocity profile in cycling derived from mechanical energy analysis.

The contributions of this article are twofold. One is procedure for determining the angular velocity profile in seated cycling that maintains the total mechanical energy of both legs constant. A five-bar linkage model (thigh, shank, foot, crank and frame) of seated (fixed hip) cycling served for the derivation of the equations to compute potential and kinetic energies of the leg segments over a complete crank cycle. With experimentally collected pedal angle data as input, these equations were used to compute the total combined mechanical energy (sum of potential and kinetic energies of the segments of both legs) for constant angular velocity pedalling at 90 rpm. Total energy varied indicating the presence of internal work. Motivated by a desire to test the hypothesis that reducing internal work in cycling will reduce energy expenditure, a procedure was developed for determining the angular velocity profile that eliminated any change in total energy. Using data recorded from five subjects, this procedure was used to determine a reference profile for an average equivalent cadence of 90 rpm. The phase of this profile is such that highest and lowest angular velocities occur when the cranks are near vertical and horizontal respectively. The second contribution is the testing of the hypothesis that the reference angular velocity profile serves to effectively reduce internal work for the subjects whose data were used to develop this profile over the range of pedalling rates (80-100 rpm) naturally preferred. In this range, the internal work was decreased a minimum of 48% relative to the internal work associated with constant angular velocity pedalling. The acceptance of this hypothesis has relevance to the protocol for future experiments which explore the effect of reduced internal work on energy expenditure in cycling.

Anthropometry↗

PubMed1991

Rotational flexibility of the human knee due to varus/valgus and axial moments in vivo.

Knee ligamentous injuries persist in the sport of Alpine skiing. To better understand the load mechanisms which lead to injury, pure varus/valgus and pure axial moments were applied both singly and in combination to the right knees of six human test subjects. The corresponding relative knee rotations in three degrees of freedom were measured. Knee flexion angles for each test subject were 15 and 60 degrees for the individual moments and 60 degrees for the combination moments. For both knee flexion angles the hip flexion angle was 0 degrees. Leg muscles were quiescent and axial force was minimal during all tests. Tables of data include sample statistics for each of four flexibility parameters in each loading direction. Data were analyzed statistically to test for significant differences in flexibility parameters between the test conditions. In flexing the knee from 15 to 60 degrees, the resulting knee rotations under single moments depended upon flexion angle with varus, valgus, and internal rotations increasing significantly. Also, rotations were different depending on load direction; varus rotation was significantly different and greater than valgus rotation at both flexion angles. Also external rotation was significantly different and greater than internal at 15 degrees flexion, but not at 60 degrees flexion. Coupled rotations under single moments were also observed. Applying pure varus/valgus moments resulted in coupled external/internal rotations which were inconsistent and hence not significant. Applying pure axial moments resulted in consistent and hence significant varus/valgus rotations; an external axial moment induced varus rotation and an internal axial moment induced valgus rotation. For combination moments, varus/valgus rotations decreased significantly from those rotations at similar load levels in the single moment studies. Also, a varus moment significantly increased external rotation and a valgus moment significantly decreased internal rotation. These differences indicate significant interaction between corresponding load combinations. These results suggest that load interaction is a potentially important phenomenon in knee injury mechanics.

Adult↗

PubMed1990

Goniometric measurement of hip motion in cycling while standing.

The purpose of this study was to develop an instrument for quantifying the motion of the hip relative to the bicycle while cycling in the standing position. Because of the need to measure hip motion on the road as well as in the laboratory, a goniometer which locates the hip using spherical coordinates was designed. The goniometer is presented first, followed by the development of the equations that enable the distance from the joint center to the pedal spindle to be determined. The orientation of this line segment is specified by calculating two angles referenced to the frame. Also outlined are the procedures used to both calibrate the goniometer and perform an accuracy check. The results of this check indicate that the attachment point of the goniometer to the rider can be located to within 2.5 mm of the true position. The goniometer was used to record the hip movement patterns of six subjects who cycled in the standing position on a treadmill. Representative results from one test subject who cycled at 6% grade and 25 km h-1 are presented. Results indicate that the bicycle is leaned from side to side with the frequency of leaning equal to the frequency of pedalling. Extreme lean angles are +/- 6 degrees. The distance from the hip to the pedal varies approximately sinusoidally with frequency equal to pedalling rate and amplitude somewhat less than crank arm length. The absolute elevation of the hip, however, exhibits two cycles for each crank cycle. Asymmetry in the plot of elevation over a single crank cycle indicates that the pelvis rocks from side to side and that the elevation of the pelvis midpoint changes. Extreme values of the pelvis rocking angle are +/- 12 degrees. Highest pelvis midpoint elevations, however, do not occur at the same crank angles as those angles at which the pelvis rocking is extreme. It appears that the vertical motion of the hips affects pedalling mechanics when cycling in the standing position.

Anthropometry↗

PubMed1990

A method for determining lower extremity muscle-tendon lengths during flexion/extension movements.

A study was conducted to examine the relationship between muscle-tendon lengths of 16 lower extremity muscles and the flexion angle(s) of the joint(s) they cross. Anthropometric data from six subjects were obtained. Various lower extremity joint flexion angle combinations were simulated for each subject using computer software. For each simulated lower extremity position, muscle origin and insertion locations were determined based on averaged cadaveric origin/insertion information and individual anthropometric parameters. Corresponding muscle-tendon lengths were computed and normalized to segment lengths. Regression equations were derived which allow normalized muscle-tendon lengths to be estimated from known joint flexion angles. The regression equations obtained for biarticular muscles fit the data quite well giving correlation coefficients greater than 0.92. The correlation coefficients for the equations describing normalized single joint muscle-tendon lengths range from 0.77 to 0.97. The equations were then validated by comparing predicted lengths to those reported by previous investigations. Confirming the utility of the equations, the comparisons were excellent for both uniarticular and biarticular muscles. Used in conjunction with velocity data (obtained by differentiating the length data) and electromyogram recordings, these equations enable a detailed analysis of muscle function.

Adult↗

PubMed1990

Implementation of a five degree of freedom automated system to determine knee flexibility in vitro.

This article describes an automated system designed to study the complete flexibility functions of the knee in vitro. The system allows five degrees of freedom with flexion angle being fixed, though adjustable from 0 to 45 deg. Loads corresponding to each of the five motions can be applied independently and in any combination. The effect of weight bearing on knee flexibility can also be studied by including axial force as one of the five loads. The relative motions are measured with LVDT's and RVDT's, and the loads are measured with strain gage transducers. The system is digitally controlled with a closed feedback loop, allowing for any combination of programmed loads. A control algorithm on an IBM PC/AT monitors the loads on each axis and continuously adjusts stepping motors to correctly follow programmed loads. The machine coordinate system corresponds to clinically accepted definitions of motion yet retains sequence independence for rotations. Results are presented demonstrating the repeatability of using a functional definition of axis placement to align the leg within the machine. Results are also presented demonstrating the utility of the full flexibility functions of the knee, notably in the determination of significant load interactions between anterior/posterior force and internal/external torque, and varus/valgus torque and internal/external torque.

Algorithms↗