Clinical Biomechanics最新文献

{"title":"Determining the individual relationship between the step width and peak knee adduction moment during stepping in medial knee osteoarthritis","authors":"Raziyeh Baghi ,&nbsp;Wei Yin ,&nbsp;Subham Badhyal ,&nbsp;Ahmed Ramadan ,&nbsp;Giovanni Oppizzi ,&nbsp;Zongpan Li ,&nbsp;Peter Bowman ,&nbsp;Frank Henn ,&nbsp;Li-Qun Zhang","doi":"10.1016/j.clinbiomech.2025.106619","DOIUrl":"10.1016/j.clinbiomech.2025.106619","url":null,"abstract":"<div><h3>Background</h3><div>Step-width modification can reduce peak knee adduction moment during gait in individuals with knee osteoarthritis, but determining optimal subject-specific step-width without testing multiple discrete positions remains a clinical challenge.</div></div><div><h3>Method</h3><div>We investigated step-width's relationship with peak knee adduction moment in 14 individuals with medial knee osteoarthritis and 14 healthy controls using a robotic stepping system with motorized footplates moving between narrow, neutral, and wide step-widths. We analyzed peak knee adduction moment-step width relationship slopes and compared peak three-dimensional knee moments between all stepping conditions using repeated-measure ANOVA analysis.</div></div><div><h3>Findings</h3><div>Both groups showed negative peak knee adduction moment-step width slopes, indicating reduced peak knee adduction moment with wider step-widths (knee osteoarthritis: <em>P</em> = 0.019, Controls: <em>P</em> = 0.016), with knee osteoarthritis group showing significantly higher slope and intercept values (<em>P</em> &lt; 0.01, <em>P</em> &lt; 0.001). Both groups demonstrated lower peak knee adduction moment and knee adduction moment impulse with wide step-width versus narrow and neutral step-widths (all <em>P</em> &lt; 0.001). Lower peak knee adduction moment during wide step-width significantly correlated with increased tibia medial tilt (<em>P</em> &lt; 0.001), increased footplate lateral reaction force (<em>P</em> = 0.023), reduced footplate inversion reaction torque (<em>P</em> &lt; 0.001), reduced stepping speed (<em>P</em> = 0.022), and absence of knee osteoarthritis (<em>P</em> &lt; 0.001).</div></div><div><h3>Interpretation</h3><div>Wider step-width effectively reduces peak knee adduction moment and knee adduction moment impulse during stepping. The robotic stepping system enables precise subject-specific step-width determination using peak knee adduction moment-step width relationships, potentially offering individualized rehabilitation strategies for knee osteoarthritis management.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106619"},"PeriodicalIF":1.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722695","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":"Gait biomechanics and energy cost of walking after rotationplasty: A systematic review and meta-analysis compared to above-knee amputation and healthy participants","authors":"G.G.J. Krebbekx ,&nbsp;N.F.J. Waterval ,&nbsp;M.A. Brehm ,&nbsp;G.M.M.J. Kerkhoffs ,&nbsp;J.A.M. Bramer ,&nbsp;F.G.M. Verspoor","doi":"10.1016/j.clinbiomech.2025.106626","DOIUrl":"10.1016/j.clinbiomech.2025.106626","url":null,"abstract":"<div><h3>Background</h3><div>To provide insight into rotationplasty, we reviewed walking oxygen/energy cost and gait biomechanics, comparing it to above-knee amputation patients(AKA) (to inform clinical decision-making), and to healthy individuals (to assess deviation from normal).</div></div><div><h3>Methods</h3><div>A literature search was conducted on September 30, 2024, using terms: rotationplasty, oxygen/energy cost of walking, and gait biomechanics. Small case reports were excluded. Methodological quality was assessed and meta-analyses (random-effects model, including heterogeneity assessment) with forest plots were performed for walking speed, cadence, stride length, and energy cost, while gait biomechanics outcomes were described qualitatively.</div></div><div><h3>Findings</h3><div>Fifteen studies (225 rotationplasty patients) were included. Oxygen/energy cost of walking was 12.5 % lower for rotationplasty patients compared to AKA (SMD:0.57,<em>p</em> = 0.01), while was 34.5 % higher compared to healthy participants (SMD:2.55,<em>p</em> &lt; 0.001). Gait biomechanics were like AKA, except for reduced compensatory knee power on the unaffected side in rotationplasty patients. Compared to healthy participants, rotationplasty patients had lower walking speed (18.1 %,p &lt; 0.001), reduced cadence (6.8 %,<em>p</em> &lt; 0.05), shorter stride length (9.5 %,p &lt; 0.05), longer double support time, more lateral trunk and pelvic tilt, reduced knee flexion in loading response and swing, and a greater compensatory joint power with a 13.9 % higher vertical ground reaction force in the unaffected leg.</div></div><div><h3>Interpretation</h3><div>This systematic review showed that rotationplasty is energetically preferable compared to AKA as oxygen/energy cost of walking was moderately lower compared to AKA, with reduced compensatory knee and hip power on the unaffected side. Walking energy cost was higher, and gait biomechanics more deviant in rotationplasty patients compared to healthy participants.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106626"},"PeriodicalIF":1.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703976","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":"How does the stem design affect the degree of freedom of the stem version and position? A computer simulation study","authors":"Shotaro Kawamura ,&nbsp;Daisuke Hara ,&nbsp;Satoshi Hamai ,&nbsp;Goro Motomura ,&nbsp;Shinya Kawahara ,&nbsp;Taishi Sato ,&nbsp;Ryosuke Yamaguchi ,&nbsp;Takeshi Utsunomiya ,&nbsp;Yasuharu Nakashima","doi":"10.1016/j.clinbiomech.2025.106628","DOIUrl":"10.1016/j.clinbiomech.2025.106628","url":null,"abstract":"<div><h3>Background</h3><div>Controlling stem anteversion is crucial in total hip arthroplasty to prevent prosthetic impingement. The degree of freedom in stem version varies depending on the stem design. However, few studies have quantified the version freedom across different stem designs. This study aimed to quantify the differences in the version freedom and position according to stem version changes between tapered-wedge and fit-and-fill stems.</div></div><div><h3>Methods</h3><div>Fifty-one hips were examined using preoperative CT. Three-dimensional templating was performed using tapered-wedge and fit-and-fill stems. The difference between the maximum and minimum stem anteversions was defined as the version freedom. Stem alignment changes in the coronal and sagittal planes and stem depth changes according to the changes in stem version were examined. Changes in the version with respect to the native femoral version were also compared.</div></div><div><h3>Findings</h3><div>The mean version freedom for the tapered-wedge stem (21.7°) was significantly greater than that for the fit-and-fill stem (9.8°, <em>P</em> &lt; 0.0001). The stem alignment changes of the tapered-wedge stem in the coronal and sagittal planes were significantly greater than those of the fit-and-fill stem, with no significant difference in the stem depth change. The version freedom significantly correlated with stem alignment changes. Both stem designs more easily increased stem anteversion but were more limited in decreasing it relative to the native femoral anteversion.</div></div><div><h3>Interpretation</h3><div>Stem design affects the version freedom. Increased adjustability of the tapered-wedge stem may improve implant positioning. Meticulous surgical planning and precise intraoperative control remain crucial to achieving target anteversion and ensuring optimal long-term outcomes.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"129 ","pages":"Article 106628"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880203","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":"Muscle activity and postural sway during standing balance tasks in adults with hallux valgus reporting low levels of foot pain: A case-control study","authors":"Sheree E. Hurn ,&nbsp;Aaron J. Wholohan ,&nbsp;Ainslie M. Davies ,&nbsp;Karen J. Mickle ,&nbsp;Melinda M. Franettovich Smith","doi":"10.1016/j.clinbiomech.2025.106629","DOIUrl":"10.1016/j.clinbiomech.2025.106629","url":null,"abstract":"<div><h3>Background</h3><div>Hallux valgus is a common foot deformity potentially impacting balance, however previous studies report conflicting findings, and further exploration of postural sway mechanisms in hallux valgus is warranted. This study investigated the impact of hallux valgus on abductor hallucis muscle activation and postural sway during balance tasks, and correlations between foot characteristics and postural sway in hallux valgus.</div></div><div><h3>Methods</h3><div>Thirty adults with hallux valgus (mean age 53.7 ± 19.3 years) and 20 controls (mean age 50.0 ± 20.1 years) performed two static standing balance tasks: bipedal and single limb stance. Centre of pressure (COP) excursion was recorded using an AccuswayPLUS balance platform (AMTI), and surface electromyography was recorded using a MA300 system (Motion Lab Systems Inc.). Age, height, weight, self-reported foot pain, Foot Posture Index, foot mobility, hallux flexion strength and intrinsic foot muscle morphology (via ultrasound imaging) were measured.</div></div><div><h3>Findings</h3><div>There were no significant between-group differences in muscle activity or postural sway during balance tasks. The hallux valgus group had a more pronated Foot Posture Index compared to controls (<em>P</em> &lt; 0.01) and larger cross-sectional area of the abductor hallucis muscle (<em>P</em> = 0.02). Both groups reported low levels of foot pain. In hallux valgus participants, increased anteroposterior sway was associated with reduced foot mobility (<em>r</em> = −0.45, <em>P</em> = 0.02), and greater COP path excursion was associated with reduced abductor hallucis cross-sectional area (<em>r</em> = −0.45, <em>P</em> = 0.04).</div></div><div><h3>Interpretation</h3><div>Adults with hallux valgus reporting low levels of foot pain and showing no substantial intrinsic foot muscle atrophy or weakness, may demonstrate static postural control equivalent to age-matched controls.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106629"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694421","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":"Hip-related symptom duration is associated with alterations in hip mechanics during a single leg squat","authors":"Holly M. Stanze ,&nbsp;Bethany J. Wilcox ,&nbsp;Anthony A. Mangino ,&nbsp;Michael A. Samaan ,&nbsp;Kate N. Jochimsen","doi":"10.1016/j.clinbiomech.2025.106630","DOIUrl":"10.1016/j.clinbiomech.2025.106630","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with hip joint-related pain (HRP) exhibit altered movement patterns compared to asymptomatic controls and high kinesiophobia. Potential differences in kinesiophobia, movement, and hip pain during movement between individuals with shorter- and longer-term HRP are not well understood. The purpose of this study was to analyze whether self-reported hip pain during a single leg squat task, kinesiophobia, and total support moment parameters during the eccentric and concentric phases of a single leg squat task differ based on hip symptom duration in individuals with HRP.</div></div><div><h3>Methods</h3><div>Involved limb hip, knee, and ankle sagittal plane moments during the single leg squat were obtained for 25 individuals with HRP. Participants completed the TSK-11 and reported hip pain during the squat. The total support moment was calculated by summing the average hip extensor, knee extensor and ankle plantarflexor moments during the squat. Between-group differences in TSK-11 scores, hip pain and total support moment parameters were assessed using independent <em>t</em>-tests and Mann-Whitney <em>U</em> tests.</div></div><div><h3>Findings</h3><div>The longer symptom duration group exhibited lower average hip extensor moments and lower hip joint contributions to the total support moment during both phases of the squat. Despite similar levels of kinesiophobia, the longer symptom duration group reported significantly higher hip pain during the squat.</div></div><div><h3>Interpretation</h3><div>Alterations in lower-limb mechanics observed in the longer symptom duration group may be associated with more severe hip-related pain as opposed to higher kinesiophobia. Further study is required to determine the association between kinesiophobia and movement patterns in individuals with HRP.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106630"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711785","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":"Fixation of surface microarchitecture for interbody fusion devices under spondylolisthesis loading conditions","authors":"Nicholas G. Lamb ,&nbsp;Sophia N. Sangiorgio ,&nbsp;Matt Zoghi ,&nbsp;Eddie Ebramzadeh ,&nbsp;John R. Ehteshami","doi":"10.1016/j.clinbiomech.2025.106631","DOIUrl":"10.1016/j.clinbiomech.2025.106631","url":null,"abstract":"<div><h3>Background</h3><div>Initial stability between a lumbar fusion cage and the vertebral endplates, particularly under the adverse loading conditions characteristic of spondylolisthesis, is vital for osseointegration and fusion. The aim of this study was to compare fixation strength and stability of surface microarchitecture designs of interbody fusion devices under shear loading in synthetic bone as a function of bone density and sagittal inclination.</div></div><div><h3>Methods</h3><div>Two surface design parameters were evaluated, serration height and pattern (1 mm-triangle 2 mm-triangle, and 2 mm-wedge serration patterns), under 30° and 45° of sagittal inclination. Each surface design and inclination combination was tested in three types of bone quality simulated using polyurethane foam with varying density and porosity.</div></div><div><h3>Findings</h3><div>Overall, sagittal migration and cyclic micromotion of the 2 mm wedge design were significantly larger than the other surface designs. Sagittal migration was 68 % to 95 % greater for the 2 mm-wedge design at similar forces, and 28 % to 63 % greater in cyclic micromotion. These differences were less pronounced when inclination was increased and/or bone density was decreased.</div></div><div><h3>Interpretations</h3><div>The results of this study indicated that surface serrations with tips closer aligned to the direction of shear force at the endplate, such as the wedge design, lead to greater migration and micromotion. Among the factors investigated, total sagittal migration was more heavily impacted by surface microarchitecture than micromotion and maximum force. Surface microarchitecture had a smaller effect on stability than bone density under higher inclination. Therefore, differences in bone quality and inclination are important considerations when selecting or designing interbody fusion devices.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106631"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686989","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":"Knee joint moment changes and the relationship to radiological severity and body weight following a structured education and exercise therapy intervention for knee osteoarthritis","authors":"Jacqui M. Couldrick ,&nbsp;Andrew P. Woodward ,&nbsp;Joseph T. Lynch ,&nbsp;Nicholas A.T. Brown ,&nbsp;Christian J. Barton ,&nbsp;Jennie M. Scarvell","doi":"10.1016/j.clinbiomech.2025.106627","DOIUrl":"10.1016/j.clinbiomech.2025.106627","url":null,"abstract":"<div><h3>Background</h3><div>Evidence links knee joint loads to knee osteoarthritis progression, making load reduction a target for non-surgical interventions. Exercise therapy does not appear to reduce knee joint moments, but studies focus on the medial compartment, overlook severity in other compartments and the influence of body weight, and do not assess more demanding tasks. This study evaluated whether knee adduction and knee flexion moments decrease following exercise therapy. We examined the extent to which knee joint moments change during a more demanding task, chair-rise, and the influence of body weight and osteoarthritis compartment severity.</div></div><div><h3>Methods</h3><div>Thirty-one participants with knee osteoarthritis underwent three-dimensional biomechanical analysis during walking and chair rises at baseline and week-8 after the Good Life with OsteoArthritis in Denmark intervention. Multilevel models estimated knee adduction and knee flexion moments and their relationships with osteoarthritis compartment severity and body weight.</div></div><div><h3>Findings</h3><div>Both knee adduction and knee flexion moments reduced during chair-rise after the intervention. The first peak knee adduction moment increased slightly by 3 % from 41.7 Nm (90 % CrI 37.0, 46.5) to 43.0 Nm (38.5, 47.5) during walking, regardless of osteoarthritis compartment severity. Greater lateral and patellofemoral compartment severity was related to larger knee flexion moment reductions during walking and chair-rises. Weak relationships were found between body weight and knee adduction and knee flexion moments for both tasks. Following the intervention, heavier people had larger increases during walking, but this was uncertain.</div></div><div><h3>Interpretation</h3><div>Intervention had minimal impact on the knee adduction moment during walking, regardless of compartment severity. Reductions in knee joint moments were observed during chair-rises. Changes in joint load following exercise therapy may be more apparent during demanding tasks. The relationship between knee flexion moment and joint load during demanding tasks warrants further investigation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106627"},"PeriodicalIF":1.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703977","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":"Effects of protruding knob heights in site-specific somatosensory foot orthoses on postural balance in older adults: A dose-response study","authors":"Abu Jor ,&nbsp;Toshiki Kobayashi ,&nbsp;Chun Hei Lai ,&nbsp;Mohammad Jobair Khan ,&nbsp;Wing-Kai Lam ,&nbsp;Fan Gao ,&nbsp;Stanley J. Winser ,&nbsp;Ming Zhang","doi":"10.1016/j.clinbiomech.2025.106624","DOIUrl":"10.1016/j.clinbiomech.2025.106624","url":null,"abstract":"<div><h3>Background</h3><div>The aging process involves many physiological changes that can significantly affect postural balance and stability. This study examines the effects of varying the height of protruding knobs in site-specific stimulating foot orthoses on postural balance and stability in older adults.</div></div><div><h3>Methods</h3><div>A crossover trial was conducted with 10 older adults aged 65 and above. Participants were randomly assigned to four different foot orthosis conditions with varying protruding knobs heights: flat foot orthosis without knobs, stimulating foot orthosis with short, medium-height, and tall protruding knobs. Postural balance and stability were assessed using standardized balance and stability tests, including center of pressure trajectory, computerized dynamic posturography, and subjective feedback.</div></div><div><h3>Findings</h3><div>The current findings revealed that stimulating foot orthosis with tall protruding knobs reduced both anteroposterior and mediolateral center of pressure displacements during standing with eyes open. Additionally, stimulating foot orthosis with tall protruding knobs increased center of pressure maximum velocity during walking on sloped surfaces. In posturography assessments, stimulating foot orthosis with tall and medium-height protruding knobs improved equilibrium scores. Although the differences were not statistically significant, a trend toward decreased comfort was observed with increasing protrusion height.</div></div><div><h3>Interpretation</h3><div>Height of protruding knobs appears to induce a positive dose-response effect on enhancing postural control in older adults. However, addressing the associated discomfort through design modification is crucial for their practical application. Longitudinal study with larger sample sizes is recommended to confirm optimal dosing strategies for site-specific stimulation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106624"},"PeriodicalIF":1.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687121","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":"Low back pain influences medial-lateral trunk movement variations during sit-to-stand tasks in persons with transtibial amputation","authors":"T.E. Parr ,&nbsp;S. Farrokhi ,&nbsp;B.D. Hendershot ,&nbsp;C.M. Butowicz","doi":"10.1016/j.clinbiomech.2025.106623","DOIUrl":"10.1016/j.clinbiomech.2025.106623","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with lower-limb amputation commonly experience low back pain, which may be associated with altered movement strategies or impaired trunk control during activities of daily living, such as sit-to-stand. The aim of this study was to assess, using wearable sensors, sit-to-stand performance and trunk movement variations of persons with transtibial amputation, with and without low back pain.</div></div><div><h3>Methods</h3><div>Fifty-eight persons with unilateral transtibial amputation (28 with and 30 without low back pain) performed five sit-to-stand trials while wearing two inertial measurement units affixed to the thigh and sternum. Sit-to-stand completion time, as well as triaxial root mean square of acceleration and triaxial variance of jerk (calculated from the trunk sensor), were compared between groups.</div></div><div><h3>Findings</h3><div>There was no difference in completion time between groups (12.1 ± 3.8 vs 11.6 ± 2.9 s; <em>p</em> = 0.54), but there was greater movement variation for persons with vs. without low back pain in the medial-lateral direction (<em>p</em> = 0.042), including root mean square of acceleration for sit-to-stand (<em>p</em> = 0.049) and variance of jerk for sit-to-stand (<em>p</em> = 0.012) and stand-to-sit (<em>p</em> = 0.018).</div></div><div><h3>Interpretation</h3><div>This study indicates that accelerometer-based metrics of trunk control are able to differentiate between persons with transtibial amputation with and without low back pain, with the pain group demonstrating decreased control. The use of sensors may help guide in-clinic or at-home movement retraining or device prescriptions for improving trunk control during dynamic activities, such as sit-to-stand.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106623"},"PeriodicalIF":1.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680006","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":"AI assisted diagnosis using DEANet to improve correct diagnosis of iliac wing fracture and ischial spine fracture","authors":"Chun-Hao Tsai ,&nbsp;Kai-Cheng Lin ,&nbsp;Yen-Yu Chen ,&nbsp;Po-Chia Chen ,&nbsp;Yuan-Shun Lo ,&nbsp;Tsung-Yu Ho","doi":"10.1016/j.clinbiomech.2025.106625","DOIUrl":"10.1016/j.clinbiomech.2025.106625","url":null,"abstract":"<div><h3>Background</h3><div>Hip fractures—particularly those involving the iliac wing and ischial spine—are complex injuries that often require CT or MRI scans for accurate diagnosis. However, these imaging modalities are costly, time-consuming, and involve exposure to radiation or contrast-related risks. This study aims to develop an AI-based classification model, the Dynamic Efficient Attention Network, capable of automatically distinguishing between iliac wing and ischial spine fractures using pelvic X-ray images. The objective is to facilitate early diagnosis and reduce reliance on advanced imaging modalities.</div></div><div><h3>Methods</h3><div>The proposed method employs a dual-branch architecture that integrates EfficientNet-B0 with an Enhanced Depth-wise Separable Attention Block to enhance edge-region feature representation. The model was trained using pelvic X-ray images collected from China Medical University Hospital and evaluated based on accuracy, precision, recall, F1 score, and Intersection over Union.</div></div><div><h3>Findings</h3><div>The model achieved an accuracy of 85 % on the test dataset and demonstrated robust performance across all evaluation metrics. These findings suggest that the proposed method has the potential to function as a reliable AI-assisted diagnostic tool for the early and accurate classification of hip fractures, thereby supporting clinical decision-making and improving treatment planning.</div></div><div><h3>Interpretation</h3><div>Compared to existing approaches that rely on CT or MRI imaging, the proposed method demonstrates that advanced processing of X-ray images can yield clinically meaningful classification results. This underscores the potential of the proposed method as a cost-effective, efficient, and accessible diagnostic tool, especially in settings where access to advanced imaging modalities is limited.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106625"},"PeriodicalIF":1.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686987","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}