Clinical Biomechanics最新文献

{"title":"Association between speckle-tracking ultrasonography and isometric load of shoulder muscles in patients with subacromial pain syndrome – A cross-sectional study","authors":"Anders Falk Brekke ,&nbsp;Katrine Kindtler Krag-Andersen ,&nbsp;Lars Henrik Frich ,&nbsp;Kate Lykke Lambertsen ,&nbsp;Peter Kraglund Jacobsen ,&nbsp;Frederik Sylvest Knold ,&nbsp;Carsten Bogh Juhl ,&nbsp;Anders Holsgaard-Larsen","doi":"10.1016/j.clinbiomech.2025.106616","DOIUrl":"10.1016/j.clinbiomech.2025.106616","url":null,"abstract":"<div><h3>Background</h3><div>Subacromial pain syndrome is the leading cause of shoulder pain, commonly affecting the supraspinatus and infraspinatus rotator cuff muscles. Speckle-tracking ultrasonography offers a direct, non-invasive method to assess muscle function by measuring percentage deformation (strain) during contraction, but its application in patients with subacromial pain syndrome is unknown. The aim of the study was to investigate whether differences in muscle strain in the supraspinatus and infraspinatus muscles were associated with increasing external isometric muscle force in patients with subacromial pain syndrome.</div></div><div><h3>Methods</h3><div>This cross-sectional study assessed 24 patients with subacromial pain syndrome using speckle-tracking ultrasonography during submaximal isometric contractions (20 % to 80 % of maximal voluntary isometric contraction) of the supraspinatus and infraspinatus muscles. Muscle strain was analyzed with the commercial EchoPAC™ software. Associations between strain and external isometric force were evaluated using repeated measures ANOVA and multiple linear regression analyses (adjustment for pain, sex, and age).</div></div><div><h3>Findings</h3><div>Muscle strain generally increased with external loads (<em>p</em> &lt; 0.001), except between 60 % and 80 % of maximal voluntary isometric contraction for supraspinatus (<em>p</em> = 0.12). Strain explained a large proportion of the variance in muscle force for both supraspinatus (<em>r</em>^<em>2</em> = 0.55, p &lt; 0.001) and infraspinatus (<em>r</em>^<em>2</em> = 0.69, p &lt; 0.001).</div></div><div><h3>Interpretation</h3><div>Strain assessed via speckle-tracking ultrasonography explained a large proportion of the variation in supraspinatus and infraspinatus muscle force among patients with subacromial pain syndrome. However, from a clinical perspective, its diagnostic accuracy in distinguishing between healthy and pathological skeletal muscle conditions remains to be established.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106616"},"PeriodicalIF":1.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670282","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 hyperextension in chronic stroke: Associated biomechanical and neuromuscular factors","authors":"Süleyman Korkusuz ,&nbsp;Büşra Seçkinoğulları Korkusuz ,&nbsp;Nihat Özgören ,&nbsp;Serdar Arıtan ,&nbsp;Ali Naim Ceren ,&nbsp;Mehmet Akif Topçuoğlu ,&nbsp;Ayla Fil Balkan","doi":"10.1016/j.clinbiomech.2025.106617","DOIUrl":"10.1016/j.clinbiomech.2025.106617","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine the gait phase in which knee hyperextension occurs in stroke patients and to investigate the factors associated with knee hyperextension.</div></div><div><h3>Methods</h3><div>This study included 30 stroke patients aged between 40 and 70 years with maximum knee hyperextension during the stance phase of gait. Muscle strength was evaluated with manual muscle test, and muscle tone was assessed with the Modified Ashworth Scale. Kinematic evaluation of the patients was made using the motion analysis system. Additionally, categorisation was made according to the stance phase of gait, where knee hyperextension was at its highest.</div></div><div><h3>Findings</h3><div>A weak relationship was found between maximum knee hyperextension angle and gastrocnemius spasticity, a moderate relationship between knee flexor muscle strength, and a moderate relationship between ankle dorsiflexor muscle strength. In addition, a weak relationship was found between the maximum knee hyperextension and pelvic retraction angles. According to this clustering, it was observed that 66.67 % of the participants (20 people) showed maximum knee hyperextension in the single support phase. It was observed that the participants who had maximum knee hyperextension, especially after the mid-stance phase, had higher mean gastrocnemius spasticity. It was also observed that participants in Cluster 4, with a greater amount of maximum knee hyperextension, had the worst clinical parameters.</div></div><div><h3>Interpretation</h3><div>Our study observed that the degree of maximum knee hyperextension was related to knee flexor and ankle dorsiflexor muscle strengths, gastrocnemius spasticity and pelvic retraction. As clinical parameters worsened, maximum knee hyperextension was thought to occur late in the stance phase.</div><div><strong><em>Clinical Trial code:</em></strong> <span><span>NCT05679700</span><svg><path></path></svg></span></div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106617"},"PeriodicalIF":1.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686988","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":"Does spinopelvic alignment affect fixation stability in pelvic ring fractures?: A finite element study","authors":"Sudharshan Tripathi ,&nbsp;Yogesh Kumaran ,&nbsp;Sophia M. Soehnlen ,&nbsp;Muzammil Mumtaz ,&nbsp;Amey Kelkar ,&nbsp;Daksh Jayaswal ,&nbsp;Toshihiro Seki ,&nbsp;Takashi Sakai ,&nbsp;Carmen E. Quatman ,&nbsp;Norihiro Nishida","doi":"10.1016/j.clinbiomech.2025.106622","DOIUrl":"10.1016/j.clinbiomech.2025.106622","url":null,"abstract":"<div><h3>Background</h3><div>The pelvic ring plays a pivotal role in maintaining biomechanical stability during upright posture. While lumbopelvic fixation is effective for stabilizing unstable pelvic fractures, the influence of spinopelvic alignment, particularly sacral slope on fixation mechanics and stress on adjacent joints, has not been adequately investigated.</div></div><div><h3>Methods</h3><div>A finite element model of the lumbar spine, pelvis, and femur was used to simulate a pelvic ring fracture. Three spinopelvic configurations were analyzed (sacral slope = 20°, 26°, 32°), each stabilized with lumbopelvic fixation, with or without a cross connector. Biomechanical parameters including fracture displacement, lumbar intersegmental mobility, intervertebral disc stress, sacroiliac joint motion, and implant stress were evaluated under physiological loading.</div></div><div><h3>Findings</h3><div>A steeper sacral slope increased mobility at the L5 to S1 segment, nucleus pulposus stress, and stress at the sacroiliac joint, suggesting potential for degeneration and mechanical overload. Rod stress was also the highest in models with a steeper sacral slope. Models with a shallower sacral slope showed reduced rod and disc stress but greater pelvic tilt. Cross connectors reduced motion and stress in all configurations, especially under steep sacral slope conditions. Displacement at the sacral and pubic fractures was also greater with steep sacral slope. Fixation stability was optimal in the model with normal alignment and compromised in the steeper alignment.</div></div><div><h3>Interpretation</h3><div>To our knowledge, this is the first biomechanical study investigating how sacral slope influences the mechanical behavior of lumbopelvic fixation constructs in the setting of unstable pelvic ring fractures using finite element methods. Understanding the biomechanical effects of variations in spinopelvic parameters can aid in decision making for implant selection strategy as well as preoperative planning in high-risk patient populations. The finite element simulations suggest that higher sacral slopes may biomechanically reduce fixation stability, highlighting the potential importance of spinopelvic assessment in preoperative planning. Cross-connectors demonstrated mechanical benefits in this FE model and may be considered in high SS cases, pending further clinical validation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106622"},"PeriodicalIF":1.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665983","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":"Comparative biomechanical analysis of combined lower and middle trapezius tendon transfer vs. isolated lower trapezius tendon transfer in irreparable posterosuperior massive rotator cuff tears","authors":"Gyuna Baek ,&nbsp;Jung Gon Kim ,&nbsp;Gyu Rim Baek ,&nbsp;Genevieve Fraipont ,&nbsp;Victor Hung ,&nbsp;Chang Hee Baek ,&nbsp;Michelle H. McGarry ,&nbsp;Thay Q. Lee","doi":"10.1016/j.clinbiomech.2025.106621","DOIUrl":"10.1016/j.clinbiomech.2025.106621","url":null,"abstract":"<div><h3>Background</h3><div>Posterosuperior massive rotator cuff tears remain challenging to manage. While lower trapezius transfer restores posterior cuff function, it lacks the superior cuff's biomechanical role. Middle trapezius tendon transfer has shown efficacy in addressing superior cuff deficiencies with dynamic joint-centering and spacer effects. This study aimed to compare the biomechanical effects of lower trapezius transfer alone versus combined lower and middle trapezius transfer for posterosuperior massive rotator cuff tears.</div></div><div><h3>Methods</h3><div>Eight cadaveric shoulders were tested under four conditions: intact, posterosuperior cuff tear, lower trapezius transfer, and combined lower and middle trapezius transfer. Superior translation, subacromial contact pressure, and rotational range of motion were measured at multiple abduction and external rotation positions. Statistical analysis was performed using a linear mixed-effects model.</div></div><div><h3>Findings</h3><div>Both lower trapezius and combined lower and middle trapezius transfers significantly reduced superior humeral head translation versus the tear condition (<em>p</em> &lt; .041). The combined transfer restored translation to intact levels and was more effective than lower trapezius transfer alone at 0° and 20° abduction (<em>p</em> &lt; .031). Subacromial contact pressure decreased significantly with both transfers at 20° and 40° abduction (<em>p</em> &lt; .030), and with combined transfer also at 0° abduction and 30° ER (<em>p</em> &lt; .042). Total rotational range of motion was preserved in all conditions.</div></div><div><h3>Interpretation</h3><div>Combined lower and middle trapezius transfer offers superior biomechanical restoration of glenohumeral joint stability compared to lower trapezius transfer alone without compromising range of motion. These findings support the potential of dual tendon transfer in addressing both posterior and superior cuff deficiencies, warranting further clinical evaluation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106621"},"PeriodicalIF":1.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680005","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 3D correction and bone-screw forces as a function of rod insertion sequence and orientation relative to the sagittal plane in adolescent idiopathic scoliosis instrumentation","authors":"Camille Pillot ,&nbsp;Xiaoyu Wang ,&nbsp;Alexandria Mallinos ,&nbsp;Todd Ritzman ,&nbsp;Lorena Floccari ,&nbsp;Richard M. Schwend ,&nbsp;Carl-Eric Aubin","doi":"10.1016/j.clinbiomech.2025.106618","DOIUrl":"10.1016/j.clinbiomech.2025.106618","url":null,"abstract":"<div><h3>Background</h3><div>In adolescent idiopathic scoliosis instrumentation, rods are typically aligned with the sagittal plane during the initial translation maneuver. Surgeons often empirically orient the rod slightly opposite to the scoliotic curve, but the optimal orientation and insertion sequence, as well as their influence on 3D correction and forces, remain unclear. This study investigates the biomechanical influence of these rod parameters on scoliosis correction.</div></div><div><h3>Methods</h3><div>Patient-specific multi-body biomechanical models were developed for 30 adolescent idiopathic scoliosis patients (11 hypo-, 12 normo-, 7 hyper-kyphotic thoracic curves) to simulate posterior instrumentation with a primary segmental translation correction maneuver. Rod insertion was tested in two sequences: concave side first, followed by the convex side, and vice versa. The construct included pedicle screws and 5.5-mm Cobalt-Chromium rods contoured to 45° (concave side) and 15° (convex side). Four rod orientations relative to the sagittal plane (0°, 10°, 20°, 30°) were analyzed for 3D correction and bone-screw forces.</div></div><div><h3>Findings</h3><div>Main thoracic Cobb angle correction improved significantly with rod orientations ≥20° (<em>p</em> &lt; 0.01). Apical vertebral rotation and thoracic kyphosis correction were unaffected by rod orientation (<em>p</em> &gt; 0.05). Bone-screw forces increased slightly but not significantly (p &gt; 0.05) with greater rod orientation. Convex-side-first rod insertion reduced bone-screw forces during initial insertion, achieving corrections similar to the concave-first sequence.</div></div><div><h3>Interpretation</h3><div>Pre-contoured rods oriented up to 30° opposite the scoliotic curve significantly improved coronal plane correction, while maintaining similar thoracic kyphosis and vertebral rotation, with non-significant increases in bone-screw forces. Convex-side-first insertion may reduce mechanical stress during surgery.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106618"},"PeriodicalIF":1.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670288","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 hemispheric specialization on reactive upper limb motor control after perturbations via a newly designed reactive pinch-holding-up activity test","authors":"Hsiu-Yun Hsu ,&nbsp;Jie-Ning Yu ,&nbsp;Yu-Ching Lin ,&nbsp;Hui-Chen Su ,&nbsp;Chia-Lin Koh ,&nbsp;Li-Chieh Kuo","doi":"10.1016/j.clinbiomech.2025.106607","DOIUrl":"10.1016/j.clinbiomech.2025.106607","url":null,"abstract":"<div><h3>Background</h3><div>Reactive motor control is essential for optimizing movements, particularly in response to unexpected perturbations. Although hemispheric specialization is known to influence motor performance, its role in reactive motor control during fine motor tasks remains uncertain. This study aimed to develop a reliable reactive Pinch-Holding-Up Activity test to deliver controlled perturbations and measure reactive responses, evaluate the effects of various perturbation scenarios on grip responses, and investigate hemispheric influences on motor adaptation.</div></div><div><h3>Methods</h3><div>This cross-sectional observational study recruited 20 right-handed young adults to assess the reliability of the test and 26 participants to investigate the effects of hemispheric specialization. The reactive Pinch-Holding-Up Activity test comprised three conditions: predictive perturbation, unpredictable perturbation during holding, and unpredictable perturbation during lifting. Key parameters analyzed included reaction time, time to regain grip stability, peak grip force, force ratio, and baseline pinch force.</div></div><div><h3>Findings</h3><div>The test demonstrated good reliability, with the intraclass correlation coefficient improving from 0.571 to 0.868 after removing outliers. In the perturbation during lifting condition, both hands exhibited lower peak grip force compared to the perturbation during holding condition (<em>p</em> = 0.002 for the right hand; <em>p</em> &lt; 0.001 for the left hand). The left hand showed greater precision in timing and force adjustments under both holding and lifting conditions (<em>p</em> &lt; 0.05).</div></div><div><h3>Interpretation</h3><div>These findings indicate that the test is a reliable tool for assessing fine motor control and reveal hemispheric differences in reactive motor adaptation. The left hand's superior precision under unpredictable conditions suggests potential applications in rehabilitation and motor adaptation research.</div><div>Clinical Trial Registration: <span><span>NCT05574075</span><svg><path></path></svg></span></div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106607"},"PeriodicalIF":1.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580569","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":"Characterization of the mechanical changes of adductor muscles in the lower extremities for patients with multiple sclerosis","authors":"Tuba Maden ,&nbsp;Hakan Polat ,&nbsp;Emine Kiliçparlar Cengiz","doi":"10.1016/j.clinbiomech.2025.106606","DOIUrl":"10.1016/j.clinbiomech.2025.106606","url":null,"abstract":"<div><h3>Background</h3><div>It is important to know how the mechanical properties of the muscles change in the management of adductor spasticity in patients with Multiple Sclerosis (pwMS).</div></div><div><h3>Methods</h3><div>This study was conducted by evaluating forty-two pwMS bilaterally. The Modified Ashworth Scale (MAS) was used to determine the hip adductor spasticity level, and pwMS were divided into four groups (MAS0, MAS1, MAS1+, MAS2) regarding the MAS grade. MyotonPro® (Myoton AS, Estonia) was used to determine mechanical properties (tone, stiffness, elasticity) of the muscle from the (i) belly, (ii) musculotendinous, and (iii) tendon sites of the muscle.</div></div><div><h3>Findings</h3><div>The measurements obtained from the belly and musculotendinosus sites of the muscle were compared concerning the MAS, there was a difference in the tones and stiffness of the muscle (<em>p</em> &lt; 0.05). There was no difference in elasticity values of belly and musculotendinosus sites (<em>p</em> &gt; 0.05). Musculotendinosus sites' tone and stiffness were different between MAS0 and MAS2 (<em>p</em> &lt; 0.05). All of the myotonometer values were differences in tendon sites regarding the MAS (<em>p</em> &lt; 0.05). The relationship between elasticity and the MAS was only present in the tendon region, and a moderate negative correlation was observed between them (<em>r</em> = 0.358, p &lt; 0.05).</div></div><div><h3>Interpretation</h3><div>As spasticity progresses, the change in viscoelastic properties advances from contractile structures to non-contractile structures. Mechanical influence in the tendon area is not only confined to tone and stiffness, it also affects elasticity. In the techniques chosen for the management of spasticity, the regional characteristics of the muscle should be taken into consideration according to the severity of spasticity.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106606"},"PeriodicalIF":1.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589199","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":"Volitional protective responses to reduce impact severity during falls: A systematic review and meta-analysis","authors":"Jia-hao Shen ,&nbsp;Cindy Hui-ping Sit ,&nbsp;Stanley Sai-chuen Hui ,&nbsp;Joseph Woochol Choi ,&nbsp;Yi-jian Yang","doi":"10.1016/j.clinbiomech.2025.106608","DOIUrl":"10.1016/j.clinbiomech.2025.106608","url":null,"abstract":"<div><h3>Background</h3><div>Volitional protective responses during falls, which are voluntary motor skills that can be learned by older adults, may reduce the impact severity of a fall. The objective of this study is to classify protective responses into load sharing, body-segment flexion and muscle relaxation categories based on their biomechanical characteristics and to examine their effectiveness in reducing the impact severity during a fall.</div></div><div><h3>Methods</h3><div>Studies were searched from the inception of each database to mid-June 2024 through PubMed, Web of Science, Cochrane Library, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature. Cross-sectional studies examined the effects of volitional protective responses on reducing the impact severity of falls from standing or lower heights in adults.</div></div><div><h3>Findings</h3><div>Totally 23 studies were included in the systematic review and 14 of them were included in meta-analyses. Meta-analyses showed that the category of load sharing had a pooled effect size of 1.02 (95 % CI = 0.51 to 1.52, <em>P</em> &lt; 0.001), and the category of body-segment flexion had a pooled effect size of 2.43 (95 % CI = 0.48 to 4.38, <em>P</em> = 0.01). Protective responses with muscle relaxation had no significant pooled effect on reducing the impact severity (<em>P</em> = 0.36).</div></div><div><h3>Interpretation</h3><div>Protective responses with load sharing were effective. Body-segment flexion responses were effective overall, but their effect on reducing the impact severity of a fall varied depending on the fall direction and impact body parts. The effect of muscle relaxation on reducing impact severity is still not clear and requires further research.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106608"},"PeriodicalIF":1.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589198","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 and biomechanical function of indoor-specific versus regular custom-made footwear for people with diabetes at high risk of foot ulceration","authors":"L.E. Vossen ,&nbsp;J.J. van Netten ,&nbsp;T.E. Busch-Westbroek ,&nbsp;S.A. Bus","doi":"10.1016/j.clinbiomech.2025.106605","DOIUrl":"10.1016/j.clinbiomech.2025.106605","url":null,"abstract":"<div><h3>Background</h3><div>Custom-made footwear designed specifically for indoor use increases footwear adherence in people with diabetes at high ulcer risk. The design and biomechanical requirements of such footwear are important if they are to safely replace regular custom-made footwear for indoor use. We aimed to compare indoor-specific versus regular custom-made footwear for design characteristics and biomechanical function.</div></div><div><h3>Methods</h3><div>Indoor-specific pressure-optimized custom-made footwear (i.e. lower weight, easier to don and doff, more comfortable and breathable materials) was provided to 36 participants with diabetes, neuropathy, and a recently healed plantar foot ulcer or amputation, who already had regular pressure-optimized custom-made footwear. Both footwear types were assessed for their shoe design features and compared using Cohen's Kappa and percentage agreement. In-shoe plantar pressures were measured during walking in both footwear types, from which multiple (center-of-)pressure parameters were calculated and compared using paired <em>t</em>-tests and statistical parametric mapping.</div></div><div><h3>Findings</h3><div>Of the 36 participants, a total 132 shoes, 66 per footwear type, were analyzed. Cohen's Kappa ranged from −0.17 to 0.72 for different design features and percentage agreement from 45 % to 97 %. Outcomes for all peak pressure parameters were statistically non-significantly higher (0–3 %, <em>P</em> <em>&gt;</em> <em>0.05</em>) in the indoor-specific compared to regular footwear. Center-of-pressure parameters were also not significantly different.</div></div><div><h3>Interpretation</h3><div>No statistically significant or clinically relevant differences were found in biomechanical functions between indoor-specific and regular custom-made footwear, despite differences found in footwear design. Indoor-specific footwear is thus a biomechanically safe alternative to regular custom-made footwear for use indoors in people with diabetes at high ulcer risk.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106605"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523507","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":"Deep operator network models for predicting post-burn contraction","authors":"Selma Husanovic ,&nbsp;Ginger Egberts ,&nbsp;Alexander Heinlein ,&nbsp;Fred Vermolen","doi":"10.1016/j.clinbiomech.2025.106558","DOIUrl":"10.1016/j.clinbiomech.2025.106558","url":null,"abstract":"<div><h3>Background</h3><div>Burn injuries present a significant global health challenge. Among the most severe long-term consequences are <em>contractures</em>, which can lead to functional impairments and disfigurement. Understanding and predicting the evolution of post-burn wounds is essential for developing effective treatment strategies. Traditional mathematical models, while accurate, are often computationally expensive and time-consuming, limiting their practical application. Recent advancements in machine learning, particularly in deep learning, offer promising alternatives for accelerating these predictions.</div></div><div><h3>Methods</h3><div>This study explores the use of a <em>deep operator network</em>, a type of neural operator, as a surrogate model for finite element simulations aimed at predicting post-burn contraction across multiple wound shapes. A deep operator network was trained on three distinct initial wound shapes, with enhancements made to the architecture by incorporating initial wound shape information and applying sine augmentation to enforce boundary conditions.</div></div><div><h3>Findings</h3><div>The performance of the trained deep operator network was evaluated on a test set including finite element simulations based on convex combinations of the three basic wound shapes. The model achieved an <span><math><msup><mi>R</mi><mn>2</mn></msup></math></span> score of <span><math><mn>0.99</mn></math></span>, indicating strong predictive accuracy and generalization. Moreover, the model provided reliable predictions over an extended period of up to one year, with speedups of up to 128-fold on the Central Processing Unit and 235-fold on the Graphical Processing Unit, compared to the numerical model.</div></div><div><h3>Interpretation</h3><div>These findings suggest that deep operator networks can effectively serve as a surrogate for traditional finite element methods in simulating post-burn wound evolution, with potential applications in medical treatment planning.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106558"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513935","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}