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Multimicroelectrode stimulation within the cat L6 spinal cord: influences of electrode combinations and stimulus interleave time on knee joint extension torque.

During multimicroelectrode stimulation within the cat L6 spinal cord, the number of electrodes activated, their separation distance, and the stimulus interleave time all influenced isometric knee joint extension torque. The torque evoked by stimulation with a three electrode combination could be enhanced or suppressed when compared with that evoked by single or paired electrode stimulation. A similar difference was noted when comparing two electrode combination versus single electrode stimulation. Relative fatigue was not improved significantly by interleaving the stimuli from two or three microelectrodes. Compared with the extension torque response evoked by noninterleaved stimulation, torque evoked by interleaved stimulation with the two microelectrode combination was decreased when the electrode distance was 2.0 mm or less and increased when the electrode distance was 3.0 mm. Designing an optimal stimulation strategy for multimicroelectrode spinal cord stimulation will be challenging and complex if a suppression effect among these electrodes is to be avoided. To reduce muscle fatigue, an asynchronous, interleaved strategy of stimulation may be required.

Animals↗

Comparison of joint torque evoked with monopolar and tripolar-cuff electrodes.

Using a self-sizing spiral-cuff electrode placed on the sciatic nerve of the cat, the joint torque evoked with stimulation applied to contacts in a monopolar configuration was judged to be the same as the torque evoked by stimulation applied to contacts in a tripolar configuration. Experiments were carried out in six acute cat preparations. In each experiment, a 12-contact electrode was placed on the sciatic nerve and used to effect both the monopolar and tripolar electrode configurations. The ankle torque produced by electrically evoked isometric muscle contraction was measured in three dimensions: plantar flexion, internal rotation, and inversion. Based on the recorded ankle torque, qualitative and quantitative comparisons were performed to determine if any significant difference existed in the pattern or order in which motor nerve fibers were recruited. No significant difference was found at a 98% confidence interval in either the recruitment properties or the repeatability of the monopolar and tripolar configurations. Further, isolated activation of single fascicles within the sciatic nerve was observed. Once nerve fibers in a fascicle were activated, recruitment of that fascicle was modulated over the full range before "spill-over" excitation occurred in neighboring fascicles. These results indicate that a four contact, monopolar nerve-cuff electrode is a viable substitute for a 12 contact, tripolar nerve-cuff electrode. The results of this study are also consistent with the hypothesis that multicontact self-sizing spiral-cuff electrodes can be used in motor prostheses to provide selective control of many muscles. These findings should also apply to other neuroprostheses employing-cuff electrodes on nerve trunks.

Animals↗

Root canal preparation with FlexMaster: asessment of torque and force in relation to canal anatomy.

AIM: To investigate physical parameters of FlexMaster nickel-titanium instruments while preparing curved canals in maxillary molars in vitro. METHODOLOGY: A torque-testing platform was used to prepare root canals in 11 extracted human maxillary molars with FlexMaster rotary instruments. Peak torque and force was registered along with numbers of rotations required to shape the canals. Canals were divided into 'wide' and 'constricted' groups depending on canal volumes assessed by microcomputed tomography. Resistance to cyclic fatigue was also tested. Mean scores for each instrument type were calculated and statistically compared using anova and Scheffé post hoc tests. RESULTS: Mean torque varied between 0.1 +/- 0.1 and 0.8 +/- 0.5 N cm while mean force ranged from 4.2 +/- 2.0 to 7.3 +/- 3.5 N. Mean numbers of rotations totalled up to 18. All three variables registered showed weak correlations to preoperative canal volumes (P < 0.01) and differed significantly between 'wide' and 'constricted' canals (P < 0.001). Numbers of rotations to fracture in a cyclic fatigue test were between 348 and 1362. CONCLUSION: FlexMaster instruments generated low torque scores and were highly resistant to cyclic fatigue, whilst three instruments fractured in extremely narrow canals. Consequently, more research is required to limit fracture incidence and to optimize instrumentation guidelines.

Analysis of Variance↗

Uncoupling of in vivo torque production from EMG in mouse muscles injured by eccentric contractions.

1. The main objective of this study was to determine whether eccentric contraction-induced muscle injury causes impaired plasmalemmal action potential conduction, which could explain the injury-induced excitation-contraction coupling failure. Mice were chronically implanted with stimulating electrodes on the left common peroneal nerve and with electromyographic (EMG) electrodes on the left tibialis anterior (TA) muscle. The left anterior crural muscles of anaesthetized mice were stimulated to perform 150 eccentric (ECC) (n = 12 mice) or 150 concentric (CON) (n = 11 mice) contractions. Isometric torque, EMG root mean square (RMS) and M-wave mean and median frequencies were measured before, immediately after, and at 1, 3, 5 and 14 days after the protocols. In parallel experiments, nicotinic acetylcholine receptor (AChR) concentration was measured in TA muscles to determine whether the excitation failure elicited a denervation-like response. 2. Immediately after the ECC protocol, torque was reduced by 47-89 %, while RMS was reduced by 9-21 %; the RMS decrement was not different from that observed for the CON protocol, which did not elicit large torque deficits. One day later, both ECC and CON RMS had returned to baseline values and did not change over the next 2 weeks. However, torque production by the ECC group showed a slow recovery over that time and was still depressed by 12-30 % after 2 weeks. M-wave mean and median frequencies were not affected by performance of either protocol. 3. AChR concentration was elevated by 79 and 368 % at 3 and 5 days, respectively, after the ECC protocol; AChR concentration had returned to control levels 2 weeks after the protocol. At the time of peak AChR concentration in the ECC protocol muscles (i.e. 5 days), AChR concentration in CON protocol muscles was not different from the control level. 4. In conclusion, these data demonstrate no major role for impaired plasmalemmal action potential conduction in the excitation-contraction coupling failure induced by eccentric contractions. Additionally, a muscle injured by eccentric contractions shows a response in AChR concentration similar to a transiently denervated muscle.

Animals↗

Plantarflexion torque following reconstruction of Achilles tendinosis or rupture with flexor hallucis longus augmentation.

Nine patients treated surgically for Achilles tendon rupture (7 patients) or tendinosis (2 patients) with primary repair or debridement and augmentation with the flexor hallucis longus muscle-tendon unit were evaluated at a mean of 19 months postoperative. Subjective evaluation revealed a high level of satisfaction. All patients returned to work and only two patients reported limitation in their recreational activities. The mean post-operative AOFAS Ankle-Hindfoot Score was 90 points. Four patients reported mild occasional pain and one patient complained of moderate daily pain. Motion assessment showed a 20% increase in the hallux MTP dorsiflexion compared to the non-operative side (p = 0.045). No difference in ankle motion was noted. Cybex II+ dynamic evaluation of plantarflexion peak torque was complete on both extremities. The torque deficit on the reconstructed extremity was 20% (p = 0.01) at 120 degrees per second and 26% (p = 0.003) at 30 degrees per second. There is no significant difference between the torque deficit recorded for patients with Achilles rupture and those with Achilles tendinosis. A trend toward improved torque production with longer follow up was observed.

Achilles Tendon↗

Use of a Torque-Range-of-Motion device for objective differentiation of diabetic from normal feet in adults.

BACKGROUND: The ability of the foot and ankle complex to act as an energy absorber is reflected in its viscoelastic properties. The Torque-Range-of-Motion (TROM) device was designed to provide an effective objective assessment of foot and ankle passive mechanical function. The hypothesis of this study was that mechanical parameters derived from passive TROM curves of otherwise normal feet of adults with diabetes would be significantly different from those of adults without diabetes. METHODS: The TROM device is a single-degree-of-freedom hinge transducer system that is manually rotated through plantarflexion and dorsiflexion. The device was rotated manually with the muscles relaxed during a 50-second data acquisition period. A strain gauge provided the torque signal and a precision single-turn potentiometer provided plantarflexion-dorsiflexion angle to a two-channel portable data acquisition system. With the TROM device connected to a computer, input for instantaneous torque and range of motion was acquired and displayed as angle (degrees) versus torque (Newton-meters) on an output screen. The period provided sufficient data to average 16 to 20 cycles of motion. The study included 41 feet in adults without diabetes and 42 age-matched feet in adults with diabetes but no known foot problems. RESULTS: For a probability level of.0001 there were significant differences in hysteresis area (normal: 91.1 +/- 46.9 Nm-deg and diabetic: 161.7 +/- 65.7 Nm-deg) and both dorsiflexion (normal: 0.4 +/- 0.1 Nm/deg and diabetic: 0.9 +/- 0.3 Nm/deg) and plantarflexion stiffness (normal: 0.3 +/- 0.1 Nm/deg and diabetic: 0.7 +/- 0.3 Nm/deg). CONCLUSIONS: The feet of adults with diabetes absorb more energy during cyclic motion (thus must dissipate more energy per cycle) and are stiffer in the terminal regions (where muscle-tendon-ligament properties prevail) than are the feet of adults without diabetes. These results suggest that this passive TROM method may be a sensitive, objective measurement of the viscoelastic properties of the foot and ankle, which may be an early indicator of diabetic patients who are at risk for the development of foot problems.

Adult↗

Knee flexor torque and perceived exertion: a gender and reliability analysis.

PURPOSE: The objectives of the present study were to examine gender differences and between-day variability of isometric hamstring muscle peak torque and perceived exertion. METHODS: Subjects included 20 healthy, college-aged male (N = 10) and female (N = 10) volunteers. Each subject completed five maximal voluntary isometric hamstring muscle contractions (MVC), in a prone position, with their knee at 30 degrees flexion. Subjects then completed, in random order, isometric contractions at 10, 20, 30, 40, 50, 60, 70, 80, and 90% of their three highest averaged MVC. Perceived exertion was measured with a modified Borg CR-10 scale after each contraction. Ten randomly chosen subjects were asked to return approximately 1 wk after the initial evaluation to repeat the same procedure. Peak hamstring muscle torque was examined in absolute (N.m), relative (N.m.kg-1), and allometric-scaled (N.m.kg-n) units. Perceived exertion across the contraction intensities was modeled to a power function in order to determine the exponent and proportionality constant. RESULTS: Males generated significantly greater hamstring muscle torque than females in absolute, relative, and allometric-scaled units (P < 0.05). No significant differences in perceived exertion occurred across the submaximal contraction intensities between females and males, nor for the derived exponents and proportionality constants. Perceived exertion ratings were observed to be significantly lower (P < 0.05) across the contraction intensity range on the second day. CONCLUSIONS: The major findings demonstrated that perceived exertion did not differ between healthy young female and male adults, despite males generating significantly more hamstring muscle torque, and perceived exertion ratings decreased at similar relative contraction intensity levels across testing days.

Adult↗

Knee-flexion torque and morphology of the semitendinosus after ACL reconstruction.

PURPOSE: The present study aimed to clarify the relationship between deficits in knee-flexion torque and morphological changes in the semitendinosus muscle-tendon complex after harvesting the semitendinosus tendon for anterior cruciate ligament (ACL) reconstruction. METHODS: Isometric knee-flexion torque at 45 and 90 degrees of knee flexion was measured in limbs of 23 patients (22 +/- 4 yr) who underwent unilateral ACL reconstruction (12-43 months postoperation) using ipsilateral semitendinosus tendon. Magnetic resonance imaging scans were used to calculate the muscle volume and the muscle length of the semitendinosus and to confirm the presence of the regenerated semitendinosus tendon. RESULTS: The percentage of the knee-flexion torque of the ACL-reconstructed limb compared with that of the contralateral limb was lower at 90 degrees than at 45 degrees . The regeneration of the semitendinosus tendon-like structure was confirmed in 21 of the 23 patients. However, muscle volume and muscle length of the semitendinosus in the ACL-reconstructed limb were significantly smaller compared with in the contralateral limb. CONCLUSION: Deficits in knee-flexion torque at deep knee flexion were associated with the atrophy and shortening of the semitendinosus after harvesting the semitendinosus tendon for ACL reconstruction.

Adult↗

Relation of maximal ankle dorsiflexion angle and passive resistive torque to passive-elastic stiffness of ankle dorsiflexion stretch.

The maximal passive ankle dorsiflexion angle and the maximal passive resistive torque at this angle were measured for 81 women 20 to 84 years of age and correlated with the passive-elastic stiffness (stiffness) of an ankle dorsiflexion stretch. Pearson correlation coefficients and multiple regression analyses were used to examine whether the two clinical measurements could predict ankle stiffness. The maximal passive resistive torque showed a moderate correlation with stiffness in the full stretch range (r = .69) and high correlation with stiffness in the last half of the full stretch range (r = .84). The maximal dorsiflexion angle showed a low correlation with stiffness in the full stretch range (r = .27) and in the last half of the full stretch range (r = .36). The maximal passive resistive torque and the dorsiflexion angle together accounted for 54% of the stiffness variance in the full stretch range and 76% of the stiffness variance in the last half of the full stretch range. Thus, the clinical measurements of the maximal passive dorsiflexion angle and the maximal passive resistive torque were directly and significantly related to the ankle dorsiflexion passive-elastic stiffness and good predictors of stiffness in the last half of the passive ankle dorsiflexion stretch.

Adult↗

Effects of hole preparation on screw pullout resistance and insertional torque: a biomechanical study.

OBJECT: The authors conducted a study to assess the effect of a pilot hole preparation on screw pullout resistance and screw insertional torque. METHODS: Three different screws were tested: cancellous lateral mass screws, cortical lateral mass screws, and pedicle screws. Synthetic bone blocks were used as the host material. Each screw group was separated into two subgroups. The first subgroup of screws was inserted into the test material following pilot hole preparation. Pilot holes were prepared; a drill bit diameter size smaller than the core diameter of the screws was used. The second group of screws was inserted into the test material without pilot hole preparation (a 3- or 4-mm hole drilled for entrance site preparation only). The insertional torque was measured as the screw was advanced into the material. The screws were axially extracted from the host material at a constant speed of 2.5 mm/minute. The pullout resistances and insertional torques for the pilot hole and the nonpilot hole groups were then statistically compared. The authors found that preparation of a pilot hole caused a significant decrease in the insertional torque. The screws inserted without a pilot hole showed greater pullout resistances compared with those inserted following a pilot hole preparation; however, there was no statistically significant difference. CONCLUSIONS: The optimum screw insertion technique may involve drilling a short pilot hole and using a drill bit with a smaller diameter than the screw core diameter to increase bone-screw purchase. This applies to cancellous and cortical lateral mass screws as well as pedicle screws.

Biomechanical Phenomena↗

A comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20-month clinical study.

Oral implant treatment ad modum Brånemark was undertaken in nine patients with edentulous maxillae. Cutting torque measurements and resonance frequency analyses (RFA) were conducted at implant placement and the corresponding values were subjected to correlation analyses. The implants were also evaluated with RFA at abutment connection and at one-year follow-up in order to identify possible changes in implant stability. A total of 61 implants were inserted, of which 49 were of the Mk II self-tapping type. Two implants were lost during the study period. The cumulative torque was presented as a mean value for the upper/crestal, the middle and the lower/apical third of the implant site respectively, as well as an overall value for the whole site. The highest correlation (r = 0.84, P<0.05) was found when comparing the mean torque values of the upper/crestal portion with the resonance frequency values at implant placement. The Mk II implant sites were divided into three groups based on the values of the cutting torque, i.e. soft (group 1), medium (group 2) and dense bone (group 3). The mean value of each group was plotted against the corresponding mean value of resonance frequency measured at implant insertion. Statistical analysis showed significant differences in resonance frequency at implant insertion between groups 1 and 2 (P = 0.047) and between groups 1 and 3 (P = 0.002). When repeating the resonance frequency analyses at second stage surgery and at one-year follow-up, no significant differences were detected between any of the groups. It was shown that the stability of implants placed in softer bone seemed to "catch up" over time with more dense bone sites.

Aged↗

The effect of implant design and bone density on maximum torque and holding power for femoral neck fracture devices.

BACKGROUND AND AIMS: Displacement of internally fixed femoral neck fractures due to implant migration is a common problem. This in vitro study was performed to compare maximum torque and holding power for five different implants. MATERIAL AND METHODS: Synthetic porous material with low, medium or high density was used to simulate cancellous bone. The tested implants included three conventional screws (AO, Olmed, Hansson), one screw with threads and a barb (Hybrid), and a pin with a hook (LIH). RESULTS: The Hansson screw provided higher maximum torque in low and medium density blocks when compared with the other implants (p < 0.0001) followed by LIH, Hybrid, Olmed, and AO. For high-density blocks there was no significant difference between Hansson and Hybrid screws, both with significantly higher torque than the other implants. The maximal pullout in low-density blocks differed significantly between all five implants with the Hansson screw providing the highest holding power. For medium and high-density blocks the conventional screws had significantly higher pullout resistance compared with the Hybrid and LIH. CONCLUSION: The in vitro model used seemed to provide reproducible and clinically relevant results. There was a good correlation between material density and holding power for all implants. Screws inserted without predrilling provided higher maximal torque while maximal pull out load seemed less affected by predrilling being used or not.

Bone Density↗

Simulation of human gait using computed torque control.

This paper presents a method for the mathematical modeling of both the single and double support phases of the human gait. The governing equations are obtained by considering the linkage model to be in a floating state and the foot-ground interaction is imposed in the form of geometric constraints. Two stages for the single support phase and one stage for the double support phase are considered, each described by a different foot-ground constraint. Feedback controller functioning according to the computed torque control method is used to achieve the normal gait described by the hip and ankle trajectories. Weighted least square optimization is used to solve the redundancy of control torques during the double support phase. The geometric simulation indicates that the imposed trajectories can be realized by the proposed model with some deviations in joint motions. The control strategy is tested by artificially perturbing the trajectories. The corrective actions are able to resume the desired pattern within half cycle, but with control torque magnitudes considerably away from reasonable limits. This is attributed to the insufficiency of the planar kinematic model and the assumption that the joint torques are unbounded.

Ankle Joint↗

Frictional torque and wear of retrieved hip prostheses: a comparison between alumina/PE and Co-Cr/PE prostheses.

Frictional torque and wear were measured in 67 retrieved cups with internal diameters of 32 mm. Thirty cups were combined with alumina heads and 37 were combined with metal heads. A lower prevalence of cup loosening was observed in alumina-polyethylene implants than in metal-polyethylene implants. No relation between frictional torque and stability of implants was detected for either type, whereas retrieved cups of alumina-polyethylene implants showed lower frictional torque than those of metal-polyethylene implants. Less wear was observed in the cups of alumina-polyethylene implants (0.13 mm/y) than in those of metal-polyethylene implants (0.19 mm/y). Less wear was observed in cups without loosening than in those with loosening in both types. These results suggest that wear has a greater influence on the stability of cups than frictional torque.

Adult↗

Effects of alendronate on the removal torque of implants in rats with induced osteoporosis.

PURPOSE: In this study, the removal torques of commercially pure titanium Implants that had been implanted simultaneously with the start of treatment for osteoporosis were compared to those of a group without treatment and a healthy group. MATERIALS AND METHODS: Rats treated by ovariectomy or sham surgery at the age of 12 weeks were used. Twenty-eight days after surgery, the rats treated by ovariectomy were divided into an alendronate-treated group and an untreated (ovariectomy-control) group. At the start of administration of alendronate, a titanium implant was placed in the distal metaphysis of the femur. After 1 month of administration of alendronate and a vehicle, removal torque, the percentage of bone-implant contact (BIC), and parameters of treatment using alendronate were measured. RESULTS: The removal torque values were 10.1 +/- 1.6 Ncm for the group of osteoporotic rats that had been administered alendronate and 6.4 +/- 1.0 Ncm for the group of osteoporotic rats that did not receive alendronate, indicating that the removal torque was significantly higher in the former group than in the latter group. However, there was no significant difference between the alendronate-treated group and the healthy control group (ie, sham surgery) (9.3 +/- 1.3 Ncm). DISCUSSION AND CONCLUSION: These results suggested that implant placement together with treatment of osteoporosis is possible in the ovariectomized rat model.

Alendronate↗

A testing machine for dental air-turbine handpiece characteristics: free-running speed, stall torque, bearing resistance.

The measurement of performance characteristics of dental air turbine handpieces is of interest with respect to product comparisons, standards specifications and monitoring of bearing longevity in clinical service. Previously, however, bulky and expensive laboratory equipment was required. A portable test machine is described for determining three key characteristics of dental air-turbine handpieces: free-running speed, stall torque and bearing resistance. It relies on a special circuit design for performing a hardware integration of a force signal with respect to rotational position, independent of the rate at which the turbine is allowed to turn during both stall torque and bearing resistance measurements. Free-running speed without the introduction of any imbalance can be readily monitored. From the essential linear relationship between torque and speed, dynamic torque and, hence, power, can then be calculated. In order for these measurements to be performed routinely with the necessary precision of location on the test stage, a detailed procedure for ensuring proper gripping of the handpiece is described. The machine may be used to verify performance claims, standard compliance checks should this be established as appropriate, monitor deterioration with time and usage in the clinical environment and for laboratory investigation of design development.

Air↗

Assessment of correlation between computerized tomography values of the bone and cutting torque values at implant placement: a clinical study.

PURPOSE: The relationship between computerized tomography (CT) values of bone surrounding endosseous implants and the cutting torque values required for self-tapping during implant placement was examined for the purpose of predicting the initial stability (bone quality) during implant placement by presurgical CT scan examinations and determining whether it can be quantified. MATERIALS AND METHODS: The study sample consisted of 13 subjects with 56 implants. Sites for implant placement were determined based on CT data using implant planning software. The average CT values of the bone surrounding the simulated implants were calculated by the software. Using a stereolithographic drill guide, implants were placed at the locations indicated by the protocol. The cutting torque values required for self-tapping were measured during implant placement. The resulting CT values and cutting torque values were analyzed statistically for correlation. RESULTS: The correlation was considered significant at a level of .01 or less, and the correlation coefficient was 0.77. DISCUSSION: There was a strong correlation between CT values and cutting torque values in the clinical cases evaluated. These results indicate that it may be possible to predict and quantify initial implant stability and bone quality from presurgical CT diagnosis and implant simulation. CONCLUSION: Presurgical CT examination may be an effective technique for predicting initial stability of the implant and bone quality.

Biomechanical Phenomena↗

Can mental practice increase ankle dorsiflexor torque?

BACKGROUND AND PURPOSE: Mental practice has been shown to be effective in increasing the force production of the abductor digiti minimi muscle in the hand. The aim of this study was to determine whether mental practice could produce strength gains in the larger ankle dorsiflexor muscles, which are important during walking. SUBJECTS: Twenty-four subjects were randomly assigned to a physical practice group, a mental practice group, or a control group (8 subjects per group). METHODS: In the practice groups, subjects either physically or mentally practiced producing maximal isometric contractions for 3 sets of 10 repetitions, 3 times per week for 4 weeks. Changes in mean peak isometric torque normalized to body weight and the resulting percentage of improvement were analyzed across the 3 groups. RESULTS: Differences in raw torque production after training in the 2 practice groups resulted in significant percentages of improvement for the physical practice group (25.28%) and the mental practice group (17.13%), but not for the control group (-1.77%). The 2 practice groups were not statistically different in their maximal torque-generating capacity after training. DISCUSSION AND CONCLUSION: These findings show that mental practice in people without impairments can lead to an increase in torque production similar to that produced by physical practice. Such a technique may prove to be a useful adjunct to traditional treatment options aimed at increasing muscle strength.

Adult↗