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Biomedical subjects

T A McMahon

Publications and source records attributed to T A McMahon.

At least 19 recordsLinked to original sources

Predicting the impact response of a nonlinear single-degree-of-freedom shock-absorbing system from the measured step response.

We measured the step response of a surrogate human pelvis/impact pendulum system at force levels between 50 and 350 N. We then fit measured response curves with four different single-degree-of-freedom models, each possessing a single mass, and supports of the following types: standard linear solid, Voigt, Maxwell, and spring. We then compared model predictions of impact force during high-energy collisions (pendulum impact velocity ranging from 1.16 to 2.58 m/s) to force traces from actual impacts to the surrogate pelvis. We found that measured peak impact forces, which ranged from 1700 to 5600 N, were best predicted by the mass-spring, Maxwell, and standard linear solid models, each of which had average errors less than 3 percent. Reduced accuracy was observed for the commonly used Voigt model, which exhibited an average error of 10 percent. Considering that the surrogate pelvis system used in this study exhibited nonlinear stiffness and damping similar to that observed in simulated fall impact experiments with human volunteers, our results suggest that these simple models allow-impact forces in potentially traumatic falls to be predicted to within reasonable accuracy from the measured response of the body in safe, simulated collisions.

Accidental Falls

Decreased myocardial oxygen consumption indices in dynamic cardiomyoplasty.

BACKGROUND: To investigate the theory of decreased myocardial oxygen consumption (MVo2) in dynamic cardiomyoplasty (DCM), previous studies have calculated indices of MVo2 in DCM. These previous studies, however, used left ventricular pressure in formulas that assumed the assumed the heart to be in its native state, with the reference pressure at the epicardium assumed to be atmospheric. In DCM, however, the reference pressure at the epicardium is no longer atmospheric but rather is the compressive pressure generated by the latissimus dorsi (LD). We therefore used the transmural myocardial pressure, Pt, to calculate indices of MVo2 in DCM. METHODS AND RESULTS: A half-ellipsoidal, fluid-filled balloon was interposed between the LD and myocardium in a balloon-mediated cardiomyoplasty procedure in five goats. With commonly used LD stimulation parameters, Pt was calculated as left ventricular pressure minus balloon luminal pressure. Using Pt, the transmural tension time index (TtTI) and transmural pressure volume area (PtVA) were calculated. In another series of four goats, LD stimulation parameters were optimized and the TtTI and PtVA recalculated. With standard LD stimulation parameters, the TtTI decreased by 48%, from 15.8 to 8.2 mm Hg.s, and the PtVA by 21%, from 775 to 612 mm Hg.mL, as the LD was stimulated to contract. When the optimized parameters were used, the TtTI decreased by 45%, from 11.2 to 6.2 mm Hg.s, and the PtVA by 33%, from 1984 to 1371 mm Hg.mL. CONCLUSIONS: Our results suggest that DCM with a fluid-filled balloon decreases MVo2 as the LD contracts and that LD stimulation parameters have a determining effect on this benefit.

Animals

Hip impact velocities and body configurations for voluntary falls from standing height.

Fall dynamics have largely been ignored in the study of hip fracture etiology and in the development of hip fracture prevention strategies. In this study, we asked the following questions: (1) What are the ranges of hip impact velocities associated with a sideways fall from standing height? (2) What are the ranges of body configurations at impact? and (3) How do protective reflexes such as muscle activation or using an outstretched hand influence fall kinematics? To answer these questions, we recruited six young healthy athletes who performed voluntary sideways falls on a thick foam mattress. Several categories of falls were investigated: (a) muscle-active vs muscle-relaxed falls; (b) falls from a standing position or from walking; and (c) falls in which an outstretched arm was used to break the fall. Each fall was videotaped at 60 frames s(-1). Fall kinematics parameters were obtained by digitizing markers placed on anatomical points of interest. The mean value for vertical hip impact velocity was 2.75 ms(-1) (+ or - 0.42 ms(-1) [S.D.]). The mean value for trunk angle (the angle between the trunk and the vertical) was 17.3 degrees (+ or - 11.5 degrees [S.D.]). We found a 38 percent reduction in the trunk angle at impact, and a 7 percent reduction in hip impact velocity for relaxed vs muscle-active falls. Finally, regarding the. falls in which an outstretched arm was used, only two out of the six subjects were able to break the fall with their arm or hand. For the remaining subjects hip impact occurred first, followed by contact of the arm or hand.

Accidental Falls

The tensile behavior of demineralized bovine cortical bone.

Bone is frequently modeled as a two-phase composite of hydroxyapatite mineral crystals dispersed throughout an organic collagen matrix. However, because of the numerous limitations (e.g. small sample size, poor strain measuring techniques, rapid demineralization with acids) of previous mechanical tests of bone with its hydroxyapatite chemically removed, we have determined new, accurate data on the material properties of the demineralized bone matrix for use in these composite models. We performed tensile tests on waisted specimens of demineralized bovine cortical bone from six humeral diaphyses. Specimens were demineralized over 14 days with a 0.5 M disodium EDTA solution that was replaced daily. Atomic absorption spectrophotometry was used to track the demineralization process and to determine the effectiveness of our demineralization protocol. Mechanical tests were performed at room temperature under displacement control at an approximate strain rate of 0.5% per s. We imposed nine preconditioning cycles before a final ramp to failure, and measured gauge length displacements using a non-invasive optical technique. The resulting stress-strain curves were similar to the tensile behavior observed in mechanical tests of other collagenous tissues, exhibiting an initial non-linear 'toe' region, followed by a linear region and subsequent failure without evidence of yielding. We found an average modulus, ultimate stress, and ultimate strain of 613 MPa (S.D. = 113 MPa), 61.5 MPa (S.D. = 13.1 MPa), and 12.3% (S.D. = 0.5%), respectively. Our average modulus is approximately half the value frequently used in current composite bone analyses. These data should also have clinical relevance because the early strength of healing fractured bone depends largely on the material properties of the collagen matrix.

Analysis of Variance

Etiology and prevention of age-related hip fractures.

Falls and fall-related injuries are among the most serious and common medical problems experienced by the elderly. Hip fracture, one of the most severe consequences of falling in the elderly, occurs in only about 1% of falls. Despite this, hip fracture accounts for a large share of the disability, death, and medical costs associated with falls. As measured by their frequency, influence on quality of life, and economic cost, hip fractures are a public health problem of crisis proportions. Without successful international initiatives aimed at reducing the incidence of falls and hip fractures, the implications for allocations of health resources in this and the next century are staggering. Identifying those at risk for harmful falls requires an understanding of what kinds of falls result in injury and fracture. In elderly persons who fall, in most of whom hip bone mineral density is already several standard deviations below peak values, fall severity (as reflected in falling to the side and impacting the hip) and body habitus are important risk factors for hip fracture and touch on a domain of risk entirely missed by knowledge of bone mineral density. These findings clearly suggest that factors related to both loading and bone fragility play important roles in the etiology of hip fracture. We provide a strategy, based on engineering approaches to fracture risk prediction, for determining the relative etiologic importance of loading and bone fragility and to summarize some of what is known about both sets of factors. We define a factor of risk, phi, as the ratio of the loads applied to the hip divided by the loads necessary to cause fracture and summarize available data on the numerator and the denominator of phi. We then provide an overview of the complex interplay between the risks associated with the initiation, descent, and impact phases of a fall, thereby suggesting an organized approach for evaluating intervention efforts being used to prevent hip fractures. The findings emphasize the continuing need for combined intervention strategies that focus on fall prevention, reductions in fall severity, and maintaining or increasing femoral bone mass and strength, either through targeted exercise programs, optimal nutrition (Ca, Vitamin D), and/or in the use of osteodynamic agents. By developing and refining the factor of risk, a property that captures both the contributions of bone density and the confounding influences of body habitus and fall severity, we believe these intervention strategies can be targeted more appropriately.

Accidental Falls

Force attenuation in trochanteric soft tissues during impact from a fall.

The risk for hip fracture from a fall is known to decrease with increased body mass index (weight/height2), a relative measure of obesity. To explore whether this reduced risk is due to the protective effect of increased soft-tissue cushioning in obese individuals, we used an impact pendulum and surrogate human pelvis to conduct simulated fall impact experiments on trochanteric soft tissues harvested from the cadavers of nine elderly individuals. For each impact, the total applied energy was 140 J. Peak forces ranged from 4,050 to 6,420 N, and tissue energy absorption ranged from 8.4 to 81.6 J. Increased tissue thickness correlated strongly with both decreased peak force (r2 = 0.91) and increased tissue energy absorption (r2 = 0.76). However, peak forces in all cases were within 1 SD of previously reported average fracture forces for elderly cadaveric femora. This suggests that force attenuation in trochanteric soft tissues alone is insufficient to prevent hip fracture in falls in which an elderly person lands directly on the hip. In such falls, additional energy-absorbing mechanisms, such as breaking the fall with an outstretched hand and eccentric contraction of the quadriceps during descent, are likely to be involved if fracture does not occur.

Accidental Falls

New technique measures decreased transmural myocardial pressure in cardiomyoplasty.

BACKGROUND: We introduce the use of a fluid-filled balloon, interposed between myocardium and latissimus dorsi (LD), as a new technique to measure transmural myocardial pressure in an acute goat model of dynamic cardiomyoplasty. METHODS: A half-ellipsoidal balloon, composed of polychloryl vinyl layers, was sutured to the atrioventricular groove in 5 goats, thereby completely enveloping both ventricles. Left LD dynamic cardiomyoplasty was then performed, anchoring the LD to the felt sewing skirt of the balloon so that the LD completely covered the balloon. Left ventricular pressure and balloon pressure were measured with the stimulator in the 1:2 mode as balloon volume was varied. RESULTS: Average transmural myocardial pressure, defined as left ventricular pressure minus balloon pressure, decreased from 34.4 mm Hg to 15.6 mm Hg during stimulator-on beats (p < 0.05). CONCLUSION: These results support the conclusion that dynamic cardiomyoplasty unloads the left ventricle by decreasing wall stress. Furthermore, transmural myocardial pressure decreased more when balloon volume was increased, implying that the LD sarcomere length has an effect on wall stress. A balloon may therefore allow optimization of LD sarcomere length and thus assisted cardiac performance.

Animals

The force-velocity curve in passive whole muscle is asymmetric about zero velocity.

The force-velocity property of passive muscle was investigated to determine if a discontinuity of slope occurred at zero velocity. Isolated, unstimulated whole frog sartorius muscles were subjected to constant-velocity stretches and releases using a servo-controlled lever. The force due to damping (delta T) was calculated by subtracting the tension measured at a very low speed (1.0 mm s-1) from the tension measured at the same length while the muscle was shortening or lengthening at a particular test speed. The experiments were performed over a range of speeds at each of several lengths and at two temperatures. For comparison, the same experiments were performed using a strip of pure latex rubber and a steel spring. Curves showing the magnitude of delta T vs velocity were nearly symmetric about the zero-velocity axis for the steel spring and the rubber strip, but were markedly asymmetric for passive muscle, showing a positive delta T for lengthening at all speeds that was between four and 11 times the negative delta T for shortening at the same speed, depending on the temperature and initial stretch length. The force due to damping at a given speed increased with extension above the rest length in passive muscle but decreased with increasing length in experiments using the latex strip. Predictions obtained from a mathematical model based on a damping element in series with a lightly damped spring were fitted to the experimental measurements of delta T vs velocity. The damping parameter provisionally representing interfilamentary sliding was between six and 12 times larger for lengthening than for shortening.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Dynamic models for sideways falls from standing height.

Despite our growing understanding of the importance of fall mechanics in the etiology of hip fracture, previous studies have largely ignored the kinematics and dynamics of falls from standing height. Beginning from basic principles, we estimated peak impact force on the greater trochanter in a sideways fall from standing height. Using a one degree-of-freedom impact model, this force is determined by the impact velocity of the hip, the effective mass of that part of the body that is moving prior to impact, and the overall stiffness of the soft tissue overlying the hip. To determine impact velocity and effective mass, three different paradigms of increasing complexity were used: 1) a falling point mass or a rigid bar pivoting at its base; 2) two-link models consisting of a leg segment and a torso; and 3) three-link models including a knee. The total mechanical energy of each model before falling was equated to the total mechanical energy just prior to impact in order to estimate the hip impact velocity. In addition, the configuration of the model just before impact was used to estimate the effective mass. Our model predictions were compared with the results of an earlier experimental study with young subjects falling on a 10-inch thick mattress. Values from literature were used to estimate the soft tissue stiffness. For the models, predicted values for hip impact velocity and effective mass ranged from 2.47 to 4.34 m/s and from 15.9 to 70.0 kg, respectively. Predicted values for the peak force applied to the greater trochanter ranged from 2.90k to 9.99k N. Based on comparisons to the experimental falls, impact velocity and impact force were best predicted by a simple two-link model with the trunk at 45 degrees to the vertical at impact. A three-link model with a quadratic spring incorporated in the knee of the model was the best predictor of effective mass. Using our most accurate model, the peak impact force was 2.90k N for a 5th percentile female and 4.26k N for a 95th percentile female, thereby confirming the widely held perception that "the bigger they are, the harder they fall".

Accidental Falls

Energy-shunting hip padding system attenuates femoral impact force in a simulated fall.

Recent studies suggest that hip padding systems reduce the incidence of hip fractures during falls. However, no data exist on the force attenuating capacity of hip pads under realistic fall impact conditions, and thus it is difficult to compare the protective merit of various pad designs. Our goal is to design a comfortable hip padding system which reduces femoral impact force in a fall below the mean force required to fracture the elderly cadaveric femur. In pursuit of this objective, we designed and constructed a hip pad testing system consisting of an impact pendulum and surrogate human pelvis. We then developed a hip pad containing a shear-thickening material which allows for shunting of the impact energy away from the femur and into the surrounding soft tissue. Finally, we conducted experiments to assess whether the surrogate pelvis accurately represents the impact behavior of the human female pelvis in a fall, and to determine whether our energy-shunting pad attenuates femoral impact force in a fall more effectively than seven available padding systems. We found the surrogate pelvis accurately represented the human female pelvis in regional variation in soft tissue stiffness, total effective stiffness and damping, and impact force attenuation provided by trochanteric soft tissues. We also found that our padding system attenuated femoral impact force by 65 percent, thereby providing two times the force attenuation of the next best system. Moreover, the energy-shunting pad was the only system capable of lowering femoral impact force well below the mean force required to fracture the elderly femur in a fall loading configuration. These results suggest that the force attenuating potential of hip pads which focus on shunting energy away from the femur is superior to those which rely on absorbing energy in the pad material. While these in-vitro results are encouraging, carefully designed prospective clinical trials will be necessary to determine the efficacy of these approaches to hip fracture prevention.

Accidental Falls

Arms are different from legs: mechanics and energetics of human hand-running.

To determine whether nonlocomotor limbs (arms) differ from locomotor limbs (legs), we trained human subjects to run on their hands while supporting a fraction of their body weight. We wanted to know whether the low cost of force production and the speed-independent limb stiffness of locomotor limbs were characteristics associated with locomotion or were inherent properties of all limbs. We found that the limb stiffness of the human arm increases by 135% over less than a fourfold range in peak vertical force. In contrast, human legs and a variety of other mammalian locomotor limbs maintain a constant stiffness, regardless of speed and loading, for normal running. In addition, we explored the energetics of locomotion in hand-running. The economy of force generation (in J/N) is invariant with speed, as is found in legged locomotion. However, our results show that the metabolic cost of force generation while running on human arms is four to five times greater than the cost of force generation for the locomotor limbs of running quadrupeds.

Arm

Negative developed tension in rapidly shortening whole frog muscles.

High speed isovelocity shortening using a servo-controlled lever was performed on isolated whole frog sartorius muscles at long lengths to ensure substantial passive tension. The tension records of unstimulated control experiments were subtracted from the tension records of fully-tetanized experiments on the same muscles to yield the developed tension exerted by the contractile proteins alone. There are several main results: (1) the positive developed tension had the same relation with shortening speed observed by other researchers in single fibres with no passive tension present; (2) negative developed tension was always measured at velocities of shortening above Vmax, where Vmax (typically 1.5 muscle-lengths s-1 at 2 degrees C) is defined as the velocity of shortening observed to yield zero developed tension; (3) negative developed tension was roughly asymptotic to -0.05 T(o), where T(o) is the developed isometric tetanic tension for the muscle length at which the developed tension was measured during steady shortening; (4) negative developed tension diminished in magnitude at velocities of shortening above approximately 2.5 Vmax; (5) a 10 degrees C increase in temperature from 2 degrees C to 12 degrees C had no significant effect on the shape of the normalized force-velocity curve (%T(o) versus %Vmax), but did increase Vmax by a factor of 2.6 in agreement with the results of previous studies measuring Vmax in the absence of passive tension; (6) addition of curare in the saline bath did not affect the results.

Animals

Compressive creep behavior of bovine trabecular bone.

There are almost no published data that describe the creep behavior of trabecular bone (at the specimen level), even though the creep behavior of cortical bone has been well documented. In an effort to characterize the creep behavior of trabecular bone and to compare it with that of cortical bone, we performed uniaxial compressive creep tests on 24 cylindrical specimens of trabecular bone taken from 19 bovine proximal tibiae. Six different load levels were used, with the applied stress normalized by the specimen modulus measured prior to creep loading. We found that trabecular bone exhibits the three creep regimens (primary, secondary, and tertiary) associated with metals, ceramics, and cortical bone. All specimens eventually fractured at strains less than 3.8%. In addition, the general shape of the creep curve was independent of apparent density. Strong and highly significant power law relationships (r2 > 0.82, p < 0.001) were found between the normalized stress sigma/E0 and both time-to-failure tf and steady-state creep rate d epsilon/dt: tf = 9.66 x 10(-33) (sigma/E0)-16.18; d epsilon/dt = 2.21 x 10(33) (sigma/E0)17.65. These data indicate that the creep behaviors of trabecular and cortical bone are qualitatively similar. In addition, the strength of trabecular bone can be reduced substantially if relatively large stresses (i.e. stresses approximately half the ultimate strength) are applied for 5 h. Such strength reductions may play a role in the etiology of progressive, age-related spine fractures if adaptive bone remodeling does not arrest creep deformations.

Aging

Trabecular bone exhibits fully linear elastic behavior and yields at low strains.

Using a protocol designed to reduce experimental artifacts associated with the conventional compression test for trabecular bone, we performed in vitro mechanical testing on bovine tibial trabecular bone to obtain accurate descriptions of the elastic and yield behaviors. Reduced-section cylindrical specimens were preconditioned for eight tension-compression (+/- 0.5% strain) cycles and then loaded to failure either in tension (n = 15) or compression (n = 14). We found that the pre-yield behavior for every specimen was fully linear, indicating that the initial nonlinear 'toe' is an experimental artifact. Analysis of variance on the moduli indicated that there was no significant difference between the tensile and compressive moduli before preconditioning. However, preconditioning decreased the tensile and compressive moduli on average by 8.8% (p < 0.01) and 5.3% (p < 0.01), respectively, with the decrease in tensile modulus being larger (p < 0.01). These small but significant decreases in modulus suggest that initial yielding involves microstructural damage (as opposed to plastic slip) of individual trabeculae and also indicate that the tensile and/or the compressive yield strain of (bovine tibial) trabecular bone is less than 0.5%. The mean tensile strength was approximately 70% of the mean compressive strength, although this difference in strengths may have been affected by the preconditioning-induced damage. Taken together, these results suggest that there are more similarities between the elastic and yield behaviors of trabecular and cortical bone than had been assumed previously.

Analysis of Variance

Finite element modeling of damage accumulation in trabecular bone under cyclic loading.

A two-dimensional finite element model of an idealized trabecular bone specimen was developed to study trabecular bone damage accumulation during cyclic compressive loading. The specimen was modeled as a two-dimensional honeycomb-like structure made up of an array of hexagonal cells. Each trabecula was modeled as a linearly elastic beam element with the same material properties as cortical bone. Initial microcracks were assumed to exist within the oblique trabeculae and to grow according to the Paris law. Forces and moments were computed in each trabecula and the microcracks were allowed to propagate until fracture occurred. Between cycles, fractured trabeculae were removed from the finite element mesh, and force and moment distributions were calculated for the next cycle. This iterative process was continued until the simulated trabecular bone specimen showed a 10% reduction in modulus. Creep failure was also studied using a single cell analysis, in which a closed-form solution was obtained after prescribing the creep properties of the trabeculae. The results of the crack propagation analysis showed that fractures of only a small number of individual trabeculae can cause a substantial reduction in the modulus of the trabecular bone specimen model. Statistical tests were performed to compare the slopes and intercepts of the S-N curves of our model predictions to those of experimentally derived S-N curves for bovine trabecular bone. There was no significant difference (p > 0.2 for both slope and intercept) between our model predictions and the experimentally derived S-N curves for the low-stress, high-cycle range. For the high-stress, low-cycle range, the crack propagation model overestimated the fatigue life for a given stress level (for slope, p < 0.001), while the creep analysis agreed well with the experimental data (for slope, p > 0.2). These findings suggest that the primary failure mechanism for low-stress, high-cycle fatigue of trabecular bone is crack growth and propagation, while the primary failure mechanism for high-stress, low-cycle fatigue is creep deformation and fracture. Furthermore, our results suggest that the modulus of trabecular bone at the specimen level may be highly sensitive to fractures of individual trabeculae.

Algorithms

Running springs: speed and animal size.

Trotting and hopping animals use muscles, tendons and ligaments to store and return elastic energy as they bounce along the ground. We examine how the musculoskeletal spring system operates at different speeds and in animals of different sizes. We model trotting and hopping as a simple spring-mass system which consists of a leg spring and a mass. We find that the stiffness of the leg spring (k(leg)) is nearly independent of speed in dogs, goats, horses and red kangaroos. As these animals trot or hop faster, the leg spring sweeps a greater angle during the stance phase, and the vertical excursion of the center of mass during the ground contact phase decreases. The combination of these changes to the spring system causes animals to bounce off the ground more quickly at higher speeds. Analysis of a wide size range of animals (0.1-140 kg) at equivalent speeds reveals that larger animals have stiffer leg springs (k(leg) [symbol: see text] M0.67, where M is body mass), but that the angle swept by the leg spring is nearly independent of body mass. As a result, the resonant period of vertical vibration of the spring-mass system is longer in larger animals. The length of time that the feet are in contact with the ground increases with body mass in nearly the same way as the resonant period of vertical vibration.

Animals

Running on an incline.

Seven male subjects ran at 3.0 m/s on a motorized treadmill including a force platform under the tread. The subjects ran at each of five treadmill inclinations: +0.17, +0.077, 0, -0.077, and -0.17 radians. The position of the subjects' legs were read from ciné films (100 frames/s). Results of the film and force plate analysis generally corroborated the "hanging triangle" hypothesis, which postulates that the angle between the leg and the vertical upon foot strike does not change as the treadmill is tipped up or down. A mathematical model of running, in which the leg is represented as a nonlinear spring, made satisfactory predictions of the way many parameters of running change with the treadmill angle, including the length of the leg at touchdown and liftoff and the peak leg force in the middle of a step. The peak leg force reaches a maximum at a treadmill angle near -0.12 radians, close to the downhill angle where other authors have found a minimum in the rate of oxygen consumption.

Acceleration

Energetics of walking and running: insights from simulated reduced-gravity experiments.

On Earth, a person uses about one-half as much energy to walk a mile as to run a mile. On another planet with lower gravity, would walking still be more economical than running? When people carry weights while they walk or run, energetic cost increases in proportion to the added load. It would seem to follow that if gravity were reduced, energetic cost would decrease in proportion to body weight in both gaits. However, we find that under simulated reduced gravity, the rate of energy consumption decreases in proportion to body weight during running but not during walking. When gravity is reduced by 75%, the rate of energy consumption is reduced by 72% during running but only by 33% during walking. Because reducing gravity decreases the energetic cost much more for running than for walking, walking is not the cheapest way to travel a mile at low levels of gravity. These results suggest that the link between the mechanics of locomotion and energetic cost is fundamentally different for walking and for running.

Energy Metabolism