Clinical Biomechanics最新文献

{"title":"Nonparetic tibialis anterior muscle activity during gait: Association with step length asymmetry in chronic stroke patients","authors":"Yuichi Tsushima ,&nbsp;Kazuki Fujita ,&nbsp;Koji Hayashi ,&nbsp;Yasutaka Kobayashi","doi":"10.1016/j.clinbiomech.2025.106573","DOIUrl":"10.1016/j.clinbiomech.2025.106573","url":null,"abstract":"<div><h3>Background</h3><div>Gait disturbances following stroke often involve abnormal muscle activity of the nonparetic lower limb as a compensatory movement. Among the multiple muscles, the tibialis anterior muscle is particularly involved in balance, and tibialis anterior muscle activity may influence gait parameters such as gait speed and asymmetry. However, the role of nonparetic tibialis anterior muscle activity in hemiplegic gait is not yet fully understood.</div></div><div><h3>Methods</h3><div>This study included 19 chronic stroke patients and 19 healthy controls. Surface electromyography was employed to measure nonparetic tibialis anterior muscle activity during gait. The gait speed, swing time asymmetry index, and step length asymmetry index were analyzed. Furthermore, statistical analyses were conducted to compare muscle activity between the groups and assess correlation analysis with gait parameters.</div></div><div><h3>Findings</h3><div>Stroke patients exhibited significantly higher nonparetic tibialis anterior muscle activity during the early single support phases than the healthy controls (<em>P</em> &lt; 0.001, d = 1.30). Nonparetic tibialis anterior muscle activity during the early single support phase was negatively correlated with the step length asymmetry index (<em>P</em> = 0.02, <em>r</em> = −0.52).</div></div><div><h3>Interpretation</h3><div>The increase in nonparetic tibialis anterior muscle activity in the early single support phase is characteristic of stroke patients and may be a compensatory movement for step length asymmetry. Excessive nonparetic tibialis anterior activity may prevent recovery of paretic side swing function. While rehabilitation typically focuses on the paretic side, this study suggests that nonparetic tibialis anterior activity plays a pivotal role in achieving functional gait.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106573"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217468","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":"Effect of capsular sparing versus capsular resection on pressure changes under the tendon of the iliopsoas muscle: An experimental cadaveric study","authors":"Michal Benes ,&nbsp;Vladislav Bartak ,&nbsp;Aneta Kirsbaumova ,&nbsp;Mark M. Cullen ,&nbsp;David Kachlik ,&nbsp;Vojtech Kunc","doi":"10.1016/j.clinbiomech.2025.106575","DOIUrl":"10.1016/j.clinbiomech.2025.106575","url":null,"abstract":"<div><h3>Background</h3><div>Although several risk factors for iliopsoas impingement after total hip arthroplasty have been determined, limited data are available whether resection or preservation of the joint capsule affects the pressure underneath the iliopsoas tendon. Therefore, this study aims to test our hypothesis that capsular resection increases the pressure forced by the iliopsoas tendon at the iliopsoas notch.</div></div><div><h3>Methods</h3><div>Ten cadaveric hips were used for measuring the pressure changes under the iliopsoas tendon. First, measurements were taken in a neutral position of the hip with an increasing load applied onto the iliopsoas muscle (0–70 N). Second experiment was conducted at 10° of extension, 0°, and 30° of flexion, both with and without muscle load of 20 N. In both experiments, the pressure was tested in a capsule preserving setting, and then the same measurements were obtained after capsulectomy.</div></div><div><h3>Findings</h3><div>Capsular resection increased mean subtendinous pressure in the neutral hip position (<em>P</em> &lt; 0.0001). Significant differences were recorded with muscle load greater than 10 N (all <em>P</em> &lt; 0.02). At 10° of hip extension, the subtendinous pressure in hips with intact capsules differed significantly from those after capsulectomy, both with and without applied load (both <em>P</em> &lt; 0.0001). At 30° of hip flexion, significant difference was observed only between loaded and unloaded hips with capsulectomy (<em>P</em> = 0.0176).</div></div><div><h3>Interpretation</h3><div>This study suggests that capsular resection during total hip arthroplasty alters the physiological pressures at the iliopsoas notch. Based on these findings, capsular sparing could decrease the risk of iliopsoas impingement after total hip arthroplasty.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106575"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213308","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":"Age and activity but not lumbar spinal stenosis and muscle fatigue affect sagittal spinal alignment: A pilot study","authors":"David Koch ,&nbsp;Corina Nüesch ,&nbsp;Dominika Ignasiak ,&nbsp;Stefan Schären ,&nbsp;Stephen J. Ferguson ,&nbsp;Annegret Mündermann ,&nbsp;Cordula Netzer","doi":"10.1016/j.clinbiomech.2025.106577","DOIUrl":"10.1016/j.clinbiomech.2025.106577","url":null,"abstract":"<div><h3>Background</h3><div>Ageing is associated with changes in spinal alignment. Lumbar spinal stenosis may alter spinal alignment due to pain, muscle atrophy and fatigue. While spinal alignment and motion are crucial in lumbar spinal stenosis, the effects of age, activity, and muscle fatigue on spinal alignment remain unclear. This study investigates these factors using motion capture analysis.</div></div><div><h3>Methods</h3><div>In 11 patients with lumbar spinal stenosis (5 M/6 W; age, 71 ± 9 years; body mass index, 29 ± 5 kg/m²), 10 older controls (5 M/5F; 65 ± 5 years; 25 ± 6 kg/m²), and 10 young controls (5 M/5F; 26 ± 2 years; 22 ± 2 kg/m²), spinal alignment was assessed during standing and walking before and after a modified Biering-Sørensen test using reflective markers. The curvature of the thoracic and lumbar spine was modelled using a cubic polynomial. Spine inclination, thoracic kyphosis, lumbar lordosis and pelvic tilt were used to describe spinal alignment. The effects of group, activity and paraspinal muscle fatigue were investigated using bootstrapped mixed-effect models.</div></div><div><h3>Findings</h3><div>Patients and older controls had greater spine inclination than young controls. Spinal alignment did not differ between patients and older controls. Dynamic activity increased spine inclination, thoracic kyphosis, and pelvic tilt across all groups. Compared to non-fatigued conditions, significant spine inclination increases and lumbar lordosis decreases occurred with fatigue. A significant interaction effect for group and activity was found between patients and young controls.</div></div><div><h3>Interpretation</h3><div>Our findings suggest that age and activity, rather than lumbar spinal stenosis and muscle fatigue, play a critical role in spinal alignment. Further studies are warranted to investigate the underlying mechanisms. <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID <span><span>NCT05309447</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106577"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205216","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":"Interaction of obesity and systemic inflammation with knee extensor strength in knee osteoarthritis","authors":"L. Straatman ,&nbsp;N.K. Ivanochko ,&nbsp;J.M. Maciukiewicz ,&nbsp;B. Cowbrough ,&nbsp;K.A. Marriott ,&nbsp;D.E. Bowdish ,&nbsp;E. Wiebenga ,&nbsp;K.F. Webster ,&nbsp;P. Stratford ,&nbsp;M.R. Maly","doi":"10.1016/j.clinbiomech.2025.106569","DOIUrl":"10.1016/j.clinbiomech.2025.106569","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis is accompanied by reduced muscle strength and a greater body mass index (BMI). Large BMI from accumulated fat mass is linked with greater systemic inflammation. Separate studies show inflammation is associated with reduced muscle strength in healthy adults. The purpose of this study was to investigate whether systemic inflammatory biomarkers interact with BMI to relate with knee extensor strength, and if the relationship differs based on sex.</div></div><div><h3>Methods</h3><div>93 participants with clinical knee osteoarthritis (<em>n</em> = 59 females, <em>n</em> = 34 males) were included. Knee extensor strength (Nm) was an average of 5 maximum voluntary isometric knee extension efforts. BMI was measured while barefoot, wearing a t-shirt and shorts. Serum cytokines were obtained from venous blood samples from the antecubital fossae following a 30-min rest period. Linear regressions tested the interaction effect of each CRP and IL-10 on the relationship between knee extensor strength (dependent variable) and BMI (independent variable), for both males and females.</div></div><div><h3>Findings</h3><div>Among females with a large BMI, higher levels of IL-10 related to greater knee extensor strength (<em>t</em> = 2.18, <em>p =</em> 0.03). For males, the interaction of IL-10 (<em>t</em> = 0.61, <em>p</em> = 0.55) with CRP (<em>t</em> = −1.75, <em>p</em> = 0.09) with BMI was not significant.</div></div><div><h3>Interpretation:</h3><div>Anti-inflammatory properties of IL-10 may serve to balance the effect of an increased BMI in females by counteracting inflammation-induced muscle damage. Understanding this association provides insight into biological factors that may contribute to disease progression, serving as a potential target for therapeutic interventions.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106569"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212976","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":"Exploring gastrocnemius medialis behavior during gait in children with cerebral palsy across different gait patterns","authors":"Babette Mooijekind ,&nbsp;Marjolein M. van der Krogt ,&nbsp;Eline Flux ,&nbsp;Kaat Desloovere ,&nbsp;Francesco Cenni ,&nbsp;Annemieke I. Buizer ,&nbsp;Lynn Bar-On","doi":"10.1016/j.clinbiomech.2025.106568","DOIUrl":"10.1016/j.clinbiomech.2025.106568","url":null,"abstract":"<div><h3>Background</h3><div>Children with spastic cerebral palsy show varied gait patterns and muscle morphological alterations. We explored gastrocnemius medialis behavior during gait in typically developing children and children with cerebral palsy across different gait patterns.</div></div><div><h3>Methods</h3><div>Eighteen children with spasticity of the leg muscles (female: 8, age: 11.1 ± 3.3 y) with a diagnosis of cerebral palsy (<em>n</em> = 17) or hereditary spastic paraplegia (n = 1) and 16 typically developing children (female: 11, age: 11.2 ± 3.2 y) walked on an instrumented treadmill. Three distinct gait patterns were determined in children with cerebral palsy. Muscle-tendon unit, fascicle, belly, and tendon behavior were assessed with dynamic ultrasound imaging. Unpaired statistical non-parametric mapping (SnPM) <em>t</em>-tests and Mann-Whitney <em>U</em> tests assessed differences between children with cerebral palsy and typically developing children. One-way ANOVA SnPM tests and Kruskall-Wallis tests assessed differences across gait patterns.</div></div><div><h3>Findings</h3><div>Tendon lengthening in the first half of stance was higher in children with cerebral palsy compared to typically developing children (Δ6.6 mm), yet total tendon lengthening in stance (Δ5.3 mm) and fascicle shortening during push-off were decreased (Δ6.2 mm). Children with cerebral palsy displaying a mildly affected kinematic gait pattern showed pathological muscle belly lengthening in stance (Δ5.7 mm), while children with equinus (Δ6.4 mm) or crouch gait (Δ6.0 mm) showed reduced tendon lengthening.</div></div><div><h3>Interpretation</h3><div>Efficient gastrocnemius medialis behavior is compromised in children with spastic cerebral palsy. Children with mildly affected gait show the most deviation in muscular components involved in active force generation, while those with equinus and crouch gait also show deviations in tendinous components. Interventions aimed at improving gait should consider this aberrant behavior.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106568"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321904","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":"Impact of light toe touch support on postural stability in adults with and without chronic low back pain","authors":"Paul Sung ,&nbsp;Dongchul Lee ,&nbsp;Connor Haab ,&nbsp;Tristen McLean ,&nbsp;Spencer Upton ,&nbsp;Michael Woodruff","doi":"10.1016/j.clinbiomech.2025.106574","DOIUrl":"10.1016/j.clinbiomech.2025.106574","url":null,"abstract":"<div><h3>Background</h3><div>Light toe touch by the contralateral foot may reflect adaptive postural control strategies; however, its role during unilateral standing in adults with chronic low back pain is not fully understood. This study aimed to examine the effects of light toe touch support on postural stability during repeated unilateral standing tasks in adults with and without low back pain.</div></div><div><h3>Methods</h3><div>The study included 28 adults with low back pain and 43 control subjects. Each participant performed a 10-s standing task on the dominant limb for two trials using a stable platform with additional support from a touch of the contralateral foot. Relative stability was assessed through the center of pressure sway excursions and analyzing time-in-boundary at thresholds of 10 mm, 20 mm, 30 mm, and 40 mm.</div></div><div><h3>Findings</h3><div>In the back pain group, there was a significant increase in the number of light touches during the first trial (21.5 % compared to 11.5 % in the control group; F = 4.93, <em>p</em> = 0.03) and the second trial (17.3 % compared to 0.52 % in the control group; F = 8.64, <em>p</em> = 0.01). The groups demonstrated significant interaction on thresholds (F = 4.76, <em>p</em> = 0.03). There were significant differences across trials (F = 5.47, <em>p</em> = 0.02) and thresholds (F = 128.39, <em>p</em> &lt; 0.001).</div></div><div><h3>Interpretation</h3><div>The low back pain group experienced challenges with unilateral standing, but utilizing light toe touch support significantly enhanced postural stability. Following the first trial, compensatory patterns were incorporated into balance strategies at 20 mm thresholds to reduce fall risks.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106574"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213307","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":"Alterations of the hip total joint moment occur during walking in individuals with Marfan syndrome","authors":"Amara G. Sharp ,&nbsp;Mariana V. Jacobs ,&nbsp;Anthony A. Mangino ,&nbsp;Jody L. Clasey ,&nbsp;Mary B. Sheppard ,&nbsp;Michael A. Samaan","doi":"10.1016/j.clinbiomech.2025.106570","DOIUrl":"10.1016/j.clinbiomech.2025.106570","url":null,"abstract":"<div><h3>Background</h3><div>Marfan Syndrome is an inherited connective tissue disorder associated with musculoskeletal weakness, ligamentous laxity, and lower extremity joint pain. Approximately 46 % of individuals with Marfan Syndrome report hip-related pain yet the underlying alterations that occur in hip joint moments during gait in the Marfan population is not well understood. The purpose of this study was to assess the hip total joint moment during walking in individuals with Marfan Syndrome compared to healthy controls.</div></div><div><h3>Methods</h3><div>Overground 3D gait analysis at a fixed walking speed was conducted for eighteen individuals with Marfan Syndrome and eighteen sex and BMI matched, asymptomatic controls. The total joint moment was calculated as the square root of the sum of the squared planar internal sagittal, frontal, and transverse plane hip moments across the stance phase. Between group differences in peak hip total joint moment and the planar contributions to the peak hip total joint moments during the first and second halves of stance were assessed using an analysis of covariance.</div></div><div><h3>Findings</h3><div>Compared to the control group, the Marfan group walked with greater first peak total hip joint moments (<em>p</em> = 0.01), greater sagittal plane percent contribution (<em>p</em> = 0.03), and greater frontal plane moments (<em>p</em> = 0.02), and frontal plane contributions (<em>p</em> = 0.02) to the hip total joint moment in the first and second half of stance.</div></div><div><h3>Interpretation</h3><div>Higher internal abduction moments at the first and second peak total joint moment may serve as a biomechanical target for gait interventions to reduce hip joint loading that may be associated with hip-related pain in the Marfan population.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106570"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205215","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 systematic review of the biomechanics of orthopaedic ambulatory bracing for residual hip dysplasia","authors":"John D. Collins ,&nbsp;Victor Huayamave ,&nbsp;Charles T. Price ,&nbsp;Alessandra Carriero ,&nbsp;Vidyadhar V. Upasani ,&nbsp;Erin M. Mannen","doi":"10.1016/j.clinbiomech.2025.106562","DOIUrl":"10.1016/j.clinbiomech.2025.106562","url":null,"abstract":"<div><h3>Background</h3><div>Residual hip dysplasia may occur following initial treatment of developmental dysplasia of the hip during infancy or following surgical intervention at an older age. Mild hip dysplasia may also be discovered during early childhood. Treatments include modalities such as bracing for less severe cases and surgical intervention for more severe cases. Treatment strategies involving bracing often cease around one year of age as children change ambulatory status and become more mobile. Continued bracing with an ambulation-permitting brace may fill the gap between the common bracing treatments and the advanced need for surgical intervention. This study sought to determine whether the biomechanics of ambulatory abduction bracing have been adequately studied as an alternative to observation for mild residual dysplasia in the ambulatory toddler.</div></div><div><h3>Methods</h3><div>This systematic review on the topic was only able to identify seven studies that address bracing of children with developmental dysplasia of the hip while also of ambulatory age.</div></div><div><h3>Findings</h3><div>Of these seven studies identified, there was very little clinically useful information to provide a basis for ambulatory bracing for mild residual hip dysplasia.</div></div><div><h3>Interpretation</h3><div>This study motivates the need for future work in this largely understudied area.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106562"},"PeriodicalIF":1.4,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195136","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":"Finite element analysis of vaginal tape at different positions for the treatment of arcus tendineus fascia pelvis damage-induced stress urinary incontinence","authors":"Weijun Li ,&nbsp;Yi Zhou ,&nbsp;Chengcheng Li ,&nbsp;Yujiao Zhao ,&nbsp;Haiying Liu ,&nbsp;Lidong Zhai","doi":"10.1016/j.clinbiomech.2025.106566","DOIUrl":"10.1016/j.clinbiomech.2025.106566","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to use the finite element analysis method to simulate sling surgeries for arcus tendineus fascia pelvis damage-induced stress urinary incontinence: tension-free vaginal tape and tension-free vaginal tape - obturator, to evaluate their therapeutic effects at different positions of the urethra, and to judge the occurrence of complications through the sling-urethra interaction force which is difficult to obtain clinically.</div></div><div><h3>Methods</h3><div>Pelvic geometric model was constructed based on the MRI of a woman without pelvic floor diseases. The constraints between arcus tendineus fascia pelvis and the lateral wall of the vagina were removed to simulate arcus tendineus fascia pelvis rupture. Gradient abdominal pressure was applied to the incontinence model, and tension-free vaginal tape and tension-free vaginal tape - obturator were placed at the proximal (30 %), mid-distal (60 %), and distal ends (80 %) of the urethra, respectively.</div></div><div><h3>Findings</h3><div>All three types of slings were able to return the parameters of the urethra and bladder to normal levels. High urethral pressure was observed with proximal placement. Distal placement led to a “knot” effect and sudden pressure spikes as abdominal pressure increased. Mid-distal placement resulted in the lowest urethral pressure. The pressure between tension-free vaginal tape and the urethra was generally greater than that between tension-free vaginal tape - obturator.</div></div><div><h3>Interpretation</h3><div>Placing slings at various positions within the urethra can all treat arcus tendineus fascia pelvis damage-induced stress urinary incontinence; the mid-distal tension-free vaginal tape - obturator should be considered the preferred treatment option.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106566"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116563","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":"Biomechanical analysis of sport induced hamate stress fractures","authors":"Andrzej Jasina ,&nbsp;Sina Gräber ,&nbsp;Parisa Pourostad ,&nbsp;Volker Schöffl ,&nbsp;Magdalena Wagner ,&nbsp;Thomas Bayer ,&nbsp;Sabine Ohlmeyer ,&nbsp;Michael Simon ,&nbsp;Christoph Lutter","doi":"10.1016/j.clinbiomech.2025.106567","DOIUrl":"10.1016/j.clinbiomech.2025.106567","url":null,"abstract":"<div><h3>Background</h3><div>Bouldering is known for a high risk of hamate injuries. Over 75 % of sport climbers have signs of upper extremity overuse injuries. Training overload corresponds with bone edema and was linked to fractures of the hamate. To date, no study has addressed the pathomechanism of hamate fracture in climbing. The aim of this study was to investigate the stability of the hamate in a biomechanical setup under the tension of the flexor tendons.</div></div><div><h3>Methods</h3><div>20 fresh-frozen, unfixed human forearms were used for two test series. The test stand consisted of an modified isokinet. Tension was applied by a motor. The specimens were prepared and positioned in ulnar deviation for the first test series. Additionally, the flexor tendons of the specimens were replaced by a steel cable in the anatomical course for the second series.</div></div><div><h3>Findings</h3><div>In the first series, no fracture occurred at the hamate. Causes for termination of these measurements were tendon rupture and failure of the suture in majority of the cases. In the second setup, tension was applied to the cable with an average maximum force of 1029.4 N [105 kg]. Fracture of the hamate occurred in two out of ten cases. The mean force measured in those cases was 1008.30 N [102.8 kg].</div></div><div><h3>Interpretation</h3><div>Our results shows that it is possible for flexor tendon's tensile load to cause hamate fracture. It must be considered in patients with ulnar localized pain in the wrist, especially with a suitable sports history. Its quick diagnosis allows further therapy and rehabilitation to be initiated.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106567"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124613","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}