Clinical Biomechanics最新文献

{"title":"Prospective fall risk screening in people who use a transtibial or transfemoral prosthesis: Cut-off times from an exploratory cohort study","authors":"M.G. Finco ,&nbsp;Cody L. McDonald ,&nbsp;Sarah C. Moudy","doi":"10.1016/j.clinbiomech.2026.106751","DOIUrl":"10.1016/j.clinbiomech.2026.106751","url":null,"abstract":"<div><h3>Background</h3><div>Over 52% of people who use a lower-limb prosthesis fall once a year. Despite this knowledge, few studies have identified parameters that could help screen fall risk in clinical practice. We sought to determine if any clinical outcome measure could significantly distinguish 6-month prospective fallers from non-fallers.</div></div><div><h3>Methods</h3><div>In this exploratory cohort study, participants completed seven clinical outcome measures, walked on level-ground at their self-selected pace, completed a 12-month fall history, and reported falls every two weeks over a 6-month period. Participants were grouped by level of prosthesis use (transtibial, transfemoral), and were classified as prospective fallers or non-fallers based on whether they reported a fall over the 6-month follow-up period. Mann-Whitney <em>U</em> tests assessed statistical significance between 6-month prospective fallers and non-fallers. For parameters that were significant, area under the curve (AUC) analyses assessed clinical applicability.</div></div><div><h3>Findings</h3><div>Twenty-one individuals who use a unilateral prosthesis participated (age 57.6 ± 14.1 years). For transtibial (<em>n</em> = 14), the Four Square Step Test (FSST) and walking speed were significantly different with large effect sizes and clinical applicability (FSST <em>p</em> = 0.022, <em>g</em> = −1.122, AUC = 0.883, cut-off = 12.83 s; walking speed <em>p</em> = 0.022, <em>g</em> = −0.961, AUC = 0.883, cut-off = 1.28 m/s). For transfemoral (<em>n</em> = 7), the Timed Up and Go (TUG) was statistically significant with large effect size and clinical applicability (<em>p</em> = 0.029, <em>g</em> = −1.642, AUC = 1.000, cut-off = 9.44 s).</div></div><div><h3>Interpretation</h3><div>Cut-off times for the FSST (≥12.83 s) and walking speed (≥1.28 m/s) in transtibial prosthesis users, as well as the TUG (≥9.44 s) for transfemoral prosthesis users, may be useful to distinguish 6-month prospective fallers from non-fallers.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106751"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel measures of frontal plane knee wobbling predict anterior cruciate ligament injury in Japanese female basketball players: A prospective pilot study","authors":"Akino Aoki ,&nbsp;Kohei Koresawa ,&nbsp;Yumi No ,&nbsp;Masashi Sadakiyo ,&nbsp;Satoshi Kubota ,&nbsp;Szu-Ping Lee ,&nbsp;Kazuyoshi Gamada","doi":"10.1016/j.clinbiomech.2026.106768","DOIUrl":"10.1016/j.clinbiomech.2026.106768","url":null,"abstract":"<div><h3>Background</h3><div>To prospectively examine how lower extremity movement patterns during single-leg landings predict anterior cruciate ligament (ACL) injuries in adolescent Japanese basketball players during a 3-year follow-up period.</div></div><div><h3>Methods</h3><div>44 female basketball players, whose knee kinematics were measured using 2-dimensional video analysis during single-leg jump landings from a box 30 cm high. Peak knee valgus angle and knee wobbling during the landing task were primary measures of injury risk. Knee wobbling, defined as repeated knee valgus/varus movement, was calculated from relative frontal to sagittal motions (RFM) at 6, 12, 18, 24, and 30° of knee flexion. Higher RFM indicates that knee frontal movement is large compared to changes in knee flexion during landing. Knee valgus angle and RFM were compared prospectively between ACL-injured and uninjured athletes during a 3-year follow-up period.</div></div><div><h3>Findings</h3><div>Peak knee valgus angles at initial contact for injured and uninjured athletes were not significantly different (12.3 ± 2.4° vs. 14.8 ± 4.1°; <em>p</em> = 0.15). Five of six ACL-injured knees (83.3%) presented knee wobbling during landing. RFM at 18° knee flexion was significantly greater in injured athletes (0.42 ± 0.52) compared to uninjured athletes (0.10 ± 0.31; <em>p</em> = 0.02).</div></div><div><h3>Interpretation</h3><div>While peak knee valgus angle did not predict subsequent ACL injuries, RFM at 18° knee flexion could find the difference between groups. This study suggests that frontal plane knee wobbling may be indicative of impaired lower extremity control and thus a potential screening tool and intervention target for ACL injury prevention in female basketball players.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106768"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Component-specific kinematic analysis of the timed up and go test using inertial measurement units reflects neuromuscular impairments in patients after stroke","authors":"Satoshi Hakukawa ,&nbsp;Kanata Yoshihara ,&nbsp;Shunsuke Onuma ,&nbsp;Masahiro Ishiwatari","doi":"10.1016/j.clinbiomech.2026.106771","DOIUrl":"10.1016/j.clinbiomech.2026.106771","url":null,"abstract":"<div><h3>Background</h3><div>Stroke survivors commonly have impairments in balance, coordination, and motor control that increase fall risk and limit independence. The Timed Up and Go test (TUG) is widely used to assess mobility and fall risk, yet total time may miss neurological deficits. The objective was to determine whether component specific kinematic measures from inertial measurement units provide more sensitive indicators of impairment than a time based outcome.</div></div><div><h3>Methods</h3><div>Forty individuals with sub-acute hemiparetic stroke (mean age 73.4 ± 14.6 years; 18 men, 22 women) performed the TUG at maximal speed while wearing inertial measurement units on the pelvis and the feet. The task was segmented into five components: sit to stand, forward gait, turning, return gait, and stand to sit. Neuromuscular impairment was evaluated with the Stroke Impairment Assessment Set (SIAS). Linear regression examined associations between assessment scores and pelvic angular velocities and linear accelerations, adjusting for age and total test time.</div></div><div><h3>Findings</h3><div>Higher SIAS scores were associated with greater pelvic roll (B = 1.00, <em>p</em> = 0.003; adjusted R² = 0.48) and yaw (B = 1.88, <em>p</em> = 0.01; adjusted R² = 0.27) angular velocities during the turning phase, even after adjustment for age and TUG time. No significant associations were found for linear acceleration metrics or for total TUG time alone.</div></div><div><h3>Interpretation</h3><div>Phase specific pelvic angular velocities measured by inertial sensors are more sensitive than overall test duration for detecting stroke related motor impairment, particularly during turning. This approach may improve clinical evaluation, support individualized rehabilitation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106771"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of a rigid subacromial implant to treat massive irreparable rotator cuff tears","authors":"Cole T. Fleet ,&nbsp;Daniel S. McNeil ,&nbsp;J. Andrew I. Trenholm ,&nbsp;James A. Johnson ,&nbsp;George S. Athwal","doi":"10.1016/j.clinbiomech.2026.106762","DOIUrl":"10.1016/j.clinbiomech.2026.106762","url":null,"abstract":"<div><h3>Background</h3><div>Massive rotator cuff tears often lead to superior migration of the humeral head and abnormal shoulder kinematics and function. In an attempt to restore normal joint kinematics, a modular subacromial implant was developed and evaluated in this biomechanical cadaveric study.</div></div><div><h3>Methods</h3><div>Eight cadaveric specimens were assessed using a muscle-loading shoulder simulator that applied loads at 0, 30, and 60 degrees of glenohumeral abduction. Testing states included the intact rotator cuff (native), the simulation of a massive rotator cuff tear, and multiple implant states. Two implant thicknesses (5 and 8 mm) and two implant articular surface constraints (low &amp; high) were tested. Humeral head translation in both anterior-posterior and superior-inferior directions was measured using an optical tracking system.</div></div><div><h3>Findings</h3><div>The presence of a massive rotator cuff tear resulted in significant superior humeral head migration relative to the native state (<em>P</em> = 0.016). Both low and high constrained 5 mm thick implants restored superior-inferior humeral head position to within 1 ± 2 mm (<em>P</em> = 0.223) and 1 ± 2 mm (<em>P</em> = 0.928) respectively, of the intact position. Significant inferior translation relative to the native state was observed with both 8 mm implant designs (8 mm low constrained: −4 ± 2 mm, <em>P</em> = 0.060; 8 mm high constrained: −4 ± 2 mm, <em>P</em> = 0.060). No significant differences were observed for anterior-posterior translation.</div></div><div><h3>Interpretation</h3><div>These results demonstrate that an implant affixed to the acromion helps to restore the native position of the humeral head in the presence of a massive rotator cuff tear with superior migration. The 5 mm high constrained implant design was most effective at restoring native humeral head position.</div></div><div><h3>Level of evidence</h3><div>Basic Science; Biomechanics.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106762"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive biomechanical phenotyping framework for diabetic foot ulcer risk stratification using multi-modal gait analysis and machine learning","authors":"Mohsen Jafarzadeh ,&nbsp;Ali Tavakoli Golpaygani ,&nbsp;Farhad Tabatabaei Ghomshe","doi":"10.1016/j.clinbiomech.2026.106753","DOIUrl":"10.1016/j.clinbiomech.2026.106753","url":null,"abstract":"<div><h3>Background</h3><div>Current diabetic foot ulcer risk assessment methods lack precision in identifying high-risk biomechanical phenotypes. This study aimed to develop a comprehensive biomechanical profiling framework integrating multi-modal gait analysis with machine learning for enhanced ulcer risk stratification.</div></div><div><h3>Methods</h3><div>In this prospective cross-sectional study, we analyzed214 participants: active diabetic foot ulcer patients (<em>n</em> = 68), diabetic controls without ulceration (<em>n</em> = 73), and healthy controls (n = 73). We implemented a multi-modal assessment protocol combining high-resolution plantar pressure mapping, wearable inertial sensors, 3D motion capture, and electromyography. Machine learning algorithms included unsupervised learning for phenotyping and supervised learning for predictive modeling, validated through nested cross-validation.</div></div><div><h3>Findings</h3><div>Diabetic foot ulcer patients demonstrated significantly elevated forefoot pressures (metatarsal 1: 21.3 ± 4.8 vs 15.2 ± 3.1 N/cm², <em>p</em> &lt; 0.001), altered pressure-time integrals, and cautious gait patterns (velocity: 1.12 ± 0.14 vs 1.45 ± 0.16 m/s, p &lt; 0.001). K-means clustering revealed four distinct biomechanical phenotypes with differential ulceration risks (OR: 3.2–8.7). The random forest model achieved 94.3% accuracy (95% CI: 91.2–96.8%) in classifying diabetic foot ulcer risk using six key biomechanical features, substantially outperforming conventional methods. Dynamic center of pressure analysis identified previously unrecognized instability patterns predictive of ulcer development 6–8 months before clinical presentation.</div></div><div><h3>Interpretation</h3><div>We identified and validated novel biomechanical phenotypes with differential ulcer susceptibility. The integration of machine learning with multi-modal gait analysis enables precise risk stratification and personalized prevention strategies, representing a paradigm shift from reactive treatment to proactive, phenotype-specific diabetic foot care.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106753"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding load distribution in high tibial osteotomies: An inverse Discrete Element Analysis approach","authors":"A. Van Oevelen ,&nbsp;K. Duquesne ,&nbsp;M. Huys ,&nbsp;A. Burssens ,&nbsp;A. Chevalier ,&nbsp;G. Steenackers ,&nbsp;E. Audenaert","doi":"10.1016/j.clinbiomech.2026.106748","DOIUrl":"10.1016/j.clinbiomech.2026.106748","url":null,"abstract":"<div><h3>Background</h3><div>With up to 40% of knee osteotomies yielding suboptimal results, improved preoperative planning is needed. This study aimed to develop an inverse Discrete Element Analysis (iDEA) approach to calculate and compare patient-specific pressure patterns against traditional clinical metrics, pre- and postoperatively.</div></div><div><h3>Methods</h3><div>Eight varus knee osteotomy patients and eight matched controls were analyzed. Personalized knee geometries were generated from Weight-Bearing Computed Tomography (WBCT) scans using Statistical Shape Modeling. Automated angular measurements were conducted and Joint Space Widths (JSW) were calculated as the Euclidean distance between the femoral and tibial bones. The iDEA approach calculated preoperative, postoperative and control pressure patterns. Group comparisons utilized one-way ANOVA or Kruskal-Wallis testing, depending on normality. A Spearman rank test was performed to assess the correlation between changes in joint space width and mean stress distribution.</div></div><div><h3>Findings</h3><div>The preoperative group showed significant differences compared to the controls across all angular measurements (Hip-Knee-Ankle angle (HKA): <em>p</em> &lt; 0.001, Joint Line Conversion Angle: p &lt; 0.001, lateral Proximal Tibial Angle: <em>p</em> = 0.044) and the medial-to-lateral JSW ratio (<em>p</em> = 0.017). Postoperatively, only the HKA remained significantly different from controls (p = 0.044). Pressure calculations revealed significantly higher peak stress ratios preoperatively than in controls (<em>p</em> = 0.029). Two subjects showed postoperative worsening of JSW and pressure patterns while angular measurements improved. JSW increases were correlated with decreases in mean stress (correlation coefficient = −0.54,<em>p</em> = 0.033).</div></div><div><h3>Interpretation</h3><div>The iDEA approach quantified intra-articular pressure distributions and revealed a general normalization trend postoperatively, supporting the effectiveness of knee osteotomy. The identification of postoperative deteriorations not captured by traditional metrics, underscores the added value of the iDEA framework.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106748"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distance-related changes in gait parameters during uneven-surface walking in people with stroke versus healthy controls: A cross-sectional analysis","authors":"Yasuhiro Inui ,&nbsp;Naomichi Mizuta ,&nbsp;Yuta Terasawa ,&nbsp;Tomoya Tanaka ,&nbsp;Naruhito Hasui ,&nbsp;Kazuki Hayashida ,&nbsp;Yuki Nishi ,&nbsp;Shu Morioka","doi":"10.1016/j.clinbiomech.2026.106747","DOIUrl":"10.1016/j.clinbiomech.2026.106747","url":null,"abstract":"<div><h3>Background</h3><div>People with Stroke (PwS) struggle with walking outdoors, especially on uneven surfaces, which limits their social participation. Distance-related changes on uneven surfaces remain unclear. We compared these changes between PwS and healthy controls (HC).</div></div><div><h3>Methods</h3><div>Nineteen PwS and 19 HC walked four laps on a 10-m uneven surface. Gait speed, root mean square of trunk acceleration (stability), maximum joint angles, electromyography (EMG) amplitude, and instantaneous mean frequency (IMNF) were measured. Linear mixed models were used to compare gait-parameter changes across laps.</div></div><div><h3>Findings</h3><div>No group × lap interaction was detected for gait speed, stability, stance-phase hip extension, or swing-phase knee flexion. An interaction was observed for ankle dorsiflexion during initial contact (<em>p</em> = 0.036; decreased across laps in PwS). For EMG amplitude, tibialis anterior during initial contact showed an interaction (<em>p</em> = 0.036; increased only in HC). Regarding IMNF, gluteus medius showed a group main effect during mid-stance (<em>p</em> &lt; 0.001; higher in PwS) and an interaction during terminal stance (p = 0.036; decreased only in PwS); during mid-swing, group main effects were observed for rectus femoris (<em>p</em> = 0.044), biceps femoris (<em>p</em> = 0.011), and gluteus medius (<em>p</em> = 0.023), with higher IMNF in PwS.</div></div><div><h3>Interpretation</h3><div>PwS maintained gait speed and stability, increasing distances on uneven surfaces, showing adaptations comparable to HC. PwS did not sufficiently augment tibialis anterior amplitude, accompanied by reduced ankle dorsiflexion and limited shock absorption. Elevated IMNF indicates greater motor-unit recruitment contributing to the maintenance of joint angles, whereas gluteus medius IMNF declined during terminal stance, suggesting fatigue. Overall, adaptation was present but limited, with a risk of fatigue.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106747"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standing anterior pelvic tilt is correlated with the proximal femur shape of individuals with cam morphology","authors":"Seth J. Kussow ,&nbsp;Rich J. Lisonbee ,&nbsp;Bergen Braun ,&nbsp;Jared L. Zitnay ,&nbsp;Megan K. Mills ,&nbsp;Stephen K. Aoki ,&nbsp;Travis G. Maak ,&nbsp;Penny R. Atkins ,&nbsp;Andrew E. Anderson","doi":"10.1016/j.clinbiomech.2026.106767","DOIUrl":"10.1016/j.clinbiomech.2026.106767","url":null,"abstract":"<div><h3>Background</h3><div>Spinopelvic morphology and alignment have been theorized to play a role in causing femoroacetabular impingement syndrome symptoms in individuals with cam morphology. However, prior studies have used hip morphological and alignment measurements that are interdependent, limiting understanding of form-function relationships.</div></div><div><h3>Methods</h3><div>Statistical shape modeling and biplane videoradiography were used for accurate, 3D assessment of femur and pelvis morphology and in vivo standing hip and pelvis orientation among individuals with and without cam morphology and impingement symptoms. Group differences in standing posture and shape were assessed, along with correlations between shape and posture.</div></div><div><h3>Findings</h3><div>Patients stood with less anterior pelvic tilt and greater hip extension than asymptomatic individuals without cam morphology. A more patient-like proximal femur shape was correlated with less anterior pelvic tilt. Asymptomatic individuals with cam morphology showed no standing posture differences but had a unique pelvic shape featuring an internally rotated ilium. Further, femur and pelvis anatomical features, primarily describing changes at hip-crossing muscle attachment sites and the sacroiliac region, showed significant associations with hip and pelvis orientation in the sagittal and frontal planes.</div></div><div><h3>Interpretation</h3><div>Patients with symptomatic impingement due to cam morphology may preemptively adopt less anterior pelvic tilt to enable functional hip range of motion. The associations between shape and standing posture may identify patients best suited for treatment involving pelvic posture modification. Results support further investigation of hip crossing muscle characteristics and spinopelvic alignment during dynamic activities to strengthen understanding of the underlying mechanisms responsible for symptoms in patients with femoroacetabular impingement syndrome.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106767"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel method for screening diabetic peripheral neuropathy using fused surface electromyogram signal and mechanomyography signal","authors":"Yanbin Guo ,&nbsp;Mingyue Wang ,&nbsp;Guoping Wang ,&nbsp;Wenxuan Sun ,&nbsp;Xiao-Jian Han ,&nbsp;Lingjuan Li ,&nbsp;Xin-Hui Qu ,&nbsp;Zibo Feng","doi":"10.1016/j.clinbiomech.2025.106737","DOIUrl":"10.1016/j.clinbiomech.2025.106737","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes peripheral neuropathy (DPN), one of the most common complications in people with diabetes, can seriously undermine their quality of life. Early detection and treatment of DPN is of great significance to the diabetes population. Nerve conduction studies, the gold standard for diagnosing DPN, causes substantial discomfort for people and requires specialized personnel and expensive equipment, making it challenging to implement as a mass screening tool for DPN.</div></div><div><h3>Methods</h3><div>Here, a novel, non-invasive and convenient screening method for DPN is proposed. In the proposed method, surface electromyography and mechanomyography data are acquired in a non-invasive and painless manner from people’ dorsalis pedis muscles. The acquired data are then processed by means of downsampling, motion data extraction, and subsequently converted into images, which are utilized for diagnosing DPN or non-DPN by a convolutional neural network.</div></div><div><h3>Findings</h3><div>The proposed method is developed based on actual data from 167 people with diabetes. After 4-fold cross validation of the method, the mean accuracy, sensitivity and specificity are evaluated to be 96.15 %, 91.39 % and 98.78 % with variances of 0.003 %, 0.017 % and 0.00014 %, respectively. Furthermore, the method is preliminary tested on 21 people with diabetes, resulting in accuracy, sensitivity and specificity of 95.48 %, 90.91 % and 98.88 %, respectively. Notably, the screening process for a single diabetic using this method can be completed in under 10 min. The results above demonstrate the efficacy of the method in diagnosing DPN.</div></div><div><h3>Interpretation</h3><div>The proposed method has the considerable potential for noninvasive and convenient screening of DPN without requiring professionals or expensive equipment.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106737"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Load distribution between the radius and ulna through the forearm interosseous membrane: Effects of elbow flexion and Varus–Valgus alignment","authors":"Takahiro Yamazaki,&nbsp;Yusuke Matsuura,&nbsp;Takashi Nomoto,&nbsp;Seiji Ohtori,&nbsp;Takane Suzuki","doi":"10.1016/j.clinbiomech.2025.106742","DOIUrl":"10.1016/j.clinbiomech.2025.106742","url":null,"abstract":"<div><h3>Background</h3><div>The forearm interosseous membrane helps distribute load between the radius and ulna, yet the combined influence of elbow flexion and varus–valgus alignment on load transfer remains unclear. This study aimed to quantify interosseous membrane-mediated load transfer across elbow flexion angles under varus and valgus loading.</div></div><div><h3>Methods</h3><div>Seven fresh-frozen cadaveric forearms were tested using a custom setup with tension/compression force sensors mounted to record loads transmitted through the radius and ulna. Specimens were positioned at multiple elbow flexion angles within 0–90° under controlled varus and valgus loading. The interosseous membrane load-transfer rate was calculated from synchronized force data, and conditions were compared statistically (Wilcoxon signed-rank test).</div></div><div><h3>Findings</h3><div>The interosseous membrane load-transfer rate was significantly greater under varus than valgus loading (mean ± SD: 24.4 ± 14.8 % vs 10.1 ± 7.9 %, <em>p</em> &lt; 0.001). Across the tested elbow flexion angles, flexion had no significant effect on the load-transfer rate in either alignment condition.</div></div><div><h3>Interpretation</h3><div>Within the tested range, varus–valgus alignment, rather than elbow flexion angle, primarily determines the magnitude of interosseous membrane -mediated load transfer. These findings provide biomechanical insight relevant to understanding injury mechanisms and may inform alignment considerations during rehabilitation or immobilization.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106742"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}