Clinical Biomechanics最新文献

{"title":"To what extent do the muscles and tendons influence metabolic cost and exercise tolerance in the hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders?","authors":"Dawson S. Sheehan ,&nbsp;Jason P. Oliemans ,&nbsp;Donald W. Golden ,&nbsp;Kalinda D. Walls ,&nbsp;Eric C. Bennett ,&nbsp;Spencer J. Skaper ,&nbsp;Michael J. Asmussen ,&nbsp;Ranita H.K. Manocha ,&nbsp;Jared R. Fletcher","doi":"10.1016/j.clinbiomech.2025.106695","DOIUrl":"10.1016/j.clinbiomech.2025.106695","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) often experience chronic pain, muscle fatigue, and exercise intolerance, potentially due to altered muscle-tendon mechanics. This study investigated the influence of Achilles tendon (AT) compliance and plantar flexor muscle function on the metabolic cost of walking in individuals with and without HSD/hEDS.</div></div><div><h3>Methods</h3><div>Eleven individuals with HSD/hEDS and 11 age- and sex-matched controls completed walking trials at, below, and above their preferred walking speed. Achilles tendon stiffness, medial gastrocnemius muscle shortening, AT energy storage, pain, and lower limb electromyographic activity were evaluated during stance phase. The energy cost of walking was also computed.</div></div><div><h3>Findings</h3><div>The hypermobile conditions were associated with significantly lower AT stiffness, higher energy cost of walking and increased pain. Muscle fascicle shortening, shortening velocity, muscle energy cost and mechanical efficiency were similar between groups. Greater muscle activation and antagonist coactivation were observed in HSD/hEDS, particularly during early stance, likely reflecting compensatory mechanisms for joint instability.</div></div><div><h3>Interpretation</h3><div>Elevated cost of walking in HSD/hEDS appears driven not by increased plantar flexor work, but by a redistribution of joint work to more proximal joints. These findings suggest that altered muscle-tendon properties and neuromuscular control strategies contribute to exercise intolerance and fatigue in the Hypermobility Spectrum Disorders and hypermobile Ehlers-Danlos Syndrome.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106695"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551497","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":"Nailing versus plating in tibiotalocalcaneal arthrodesis – A biomechanical human cadaveric study","authors":"Mehar Dhillon ,&nbsp;Mark Lenz ,&nbsp;Klaus Edgar Roth ,&nbsp;Felix Christian Kohler ,&nbsp;Ivan Zderic ,&nbsp;Boyko Gueorguiev ,&nbsp;Kajetan Klos","doi":"10.1016/j.clinbiomech.2025.106687","DOIUrl":"10.1016/j.clinbiomech.2025.106687","url":null,"abstract":"<div><h3>Background</h3><div>Severe arthrosis involving ankle and subtalar joints or hindfoot deformities refractory to other forms of treatment is currently managed by tibiotalocalcaneal arthrodesis (TTCA). Relief of pain and acceptable gait pattern along with appropriate alignment are primary goals of treatment. The spectrum of techniques includes using screws, plates, external fixators and various types of intramedullary nails. The aim of this study was to compare the biomechanical stability of a plate specifically developed for hindfoot arthrodesis to an well-established nailing system.</div></div><div><h3>Methods</h3><div>Sixteen paired human cadaveric specimens were assigned to two groups for TTCA treatment via nailing or plating and tested under quasi-static and progressively increasing cyclic loading.</div></div><div><h3>Findings</h3><div>Range of motion during quasi-static testing in dorsiflexion and varus bending was significantly higher for plated specimens (<em>P</em> ≤ 0.048), with no further significant differences between the groups detected among all other loading directions (<em>P</em> ≥ 0.106). Cycles to failure and failure load were not significantly different between the groups (<em>P</em> = 0.600).</div></div><div><h3>Interpretations</h3><div>Although the intramedullary nail performed superiorly to the plate under quasi-static testing in terms of range of motion in dorsiflexion and varus bending, from a biomechanical point of view the hindfoot arthordesis plate demonstrated comparable promising outcomes under dynamic loading and could be considered as an alternative option to the nailing system for TTCA.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106687"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551440","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":"Bilateral balance improves in low and high fall risk groups after unilateral total ankle arthroplasty","authors":"Robyn M. Hansen ,&nbsp;Samantha I. Weiss ,&nbsp;Sara L. Arena ,&nbsp;Robin M. Queen","doi":"10.1016/j.clinbiomech.2025.106719","DOIUrl":"10.1016/j.clinbiomech.2025.106719","url":null,"abstract":"<div><h3>Background</h3><div>Ankle osteoarthritis (OA) affects ∼1 % of the global population and impairs postural stability, increasing fall risk. Total ankle arthroplasty (TAA) is one of the most common surgical treatments, but balance impairments may persist post-op. The study examined differences in load symmetry across time for patients with ankle OA and post-TAA at low (LFR) or high fall risk (HFR) and then compared these groups with healthy controls.</div></div><div><h3>Methods</h3><div>All participants completed a balance assessment consisting of four static stances: shoulder width (BS), feet together (BFT), semi-tandem, and tandem. Fall risk was determined pre-operatively. Ground reaction forces were collected using force plates (AMTI, Watertown, MA) and load symmetry was calculated using the normalized symmetry index (NSI). A mixed effects model analyzed interactions between group (LFR, HFR) and time (pre-op, post1yr, post2yr) for the BS and BFT stances. A chi-square analysis examined changes in fall risk group assignment over time. Differences between healthy controls and the LFR and HRF groups at post2yr were examined with a mixed effects model.</div></div><div><h3>Findings</h3><div>HFR participants showed a significant decrease in average NSI from pre-op to post1yr (<em>p</em> &lt; 0.001) and post2yr (<em>p</em> = 0.001) for BS. BFT NSI decreased significantly from pre-op to post2yr. The chi-square test indicated a significant shift toward LFR classification at post2yr (<em>p</em> = 0.021). At post2yr, there were no significant NSI differences between LFR, HFR, and controls.</div></div><div><h3>Interpretations</h3><div>TAA improves load symmetry during quiet standing, with high fall risk participants showing the most pronounced changes, indicating the potential to reduce fall risk in post-TAA older adults.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106719"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623487","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":"Differences in gait kinematics and kinetics between patients 1 year after total hip or knee arthroplasty and healthy controls","authors":"Franziska Schmitter ,&nbsp;Corina Nüesch ,&nbsp;David Koch ,&nbsp;Karl Stoffel ,&nbsp;Petros Ismailidis ,&nbsp;Annegret Mündermann","doi":"10.1016/j.clinbiomech.2025.106691","DOIUrl":"10.1016/j.clinbiomech.2025.106691","url":null,"abstract":"<div><h3>Background</h3><div>Patients undergoing unilateral total hip arthroplasty (THA) or total knee arthroplasty (TKA) often develop osteoarthritis (OA) of the contralateral knee or hip joint. The aim of the study was to compare gait kinematics and kinetics in joints of the contralateral and ipsilateral side of patients after THA or TKA to controls.</div></div><div><h3>Methods</h3><div>103 participants (45 THA; 30 TKA; 28 controls) completed three-dimensional instrumented gait analysis. Differences in lower extremity kinematic and kinetic trajectories between each patient group and controls were analyzed using statistical parametric mapping with <em>t</em>-tests (<em>p</em> &lt; 0.05).</div></div><div><h3>Findings</h3><div>Compared to controls, patients after TKA had greater hip flexion and ankle dorsiflexion angles during terminal stance and pre-swing and greater knee adduction during terminal stance and lower ankle dorsiflexion moments on the contralateral side. On the ipsilateral side, patients with TKA had greater sagittal ankle angles during loading response, greater hip angles in terminal stance and lower ankle moments than controls. THA patients had smaller hip adduction angles during loading response and larger knee flexion angles during early stance on the ipsilateral side. Patients after TKA walked slower than controls, whereas patients after THA walked at similar speeds.</div></div><div><h3>Interpretation</h3><div>Differences in kinematic and kinetic patterns compared to controls were not only evident in the operated joint but also in the adjacent and contralateral joints in patients after TKA, but only in the ipsilateral joints in patients after THA. This suggests that 1 year after surgery, patients after THA recover faster in the contralateral joints than patients after TKA.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106691"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428926","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":"Evaluation of calcium phosphate bone cement in augmenting screw hole defects in the ulna: A biomechanical study","authors":"Wasim Awal ,&nbsp;Randy Bindra ,&nbsp;Giuseppe Pastore ,&nbsp;Lawrence Baartz ,&nbsp;Alastair Quinn ,&nbsp;David Saxby","doi":"10.1016/j.clinbiomech.2025.106717","DOIUrl":"10.1016/j.clinbiomech.2025.106717","url":null,"abstract":"<div><h3>Background</h3><div>Following ulnar shortening osteotomies, plates are often removed due to discomfort or irritation. The screw holes left after plate removal act as stress risers and predispose the bone to fracture. To our knowledge, calcium phosphate cement (CPC) is yet to be investigated for its use in reinforcing screw holes. The aim of this study was to determine if filling screw holes with CPC in a synthetic anatomical ulna model will improve its immediate mechanical strength compared to leaving screw holes unfilled.</div></div><div><h3>Methods</h3><div>Eighteen synthetic anatomical ulna models were randomly divided into three equal groups. The control group was left unaltered, the drilled group received six 3.5 mm screw holes, and the CPC group had the six 3.5 mm screw holes filled with CPC. All bones were subjected to torsional loading until failure. Peak torque at failure, stiffness, and energy absorption were measured.</div></div><div><h3>Findings</h3><div>Compared to the drilled group, the CPC group had greater peak torque, stiffness, and energy absorption. Group effects on peak torque and stiffness were moderate (eta squared = 0.12 for both) but did not reach statistical significance (<em>p</em> = 0.37 and 0.38, respectively). A statistically significant group effect was found for energy absorption (<em>p</em> &lt; 0.001); but <em>post-hoc</em> analysis revealed no difference between the drilled and CPC groups.</div></div><div><h3>Interpretation</h3><div>Effect sizes suggest CPC may improve mechanical performance, albeit modestly. Clinicians may consider using CPC for reinforcing screw holes after plate removal in bones like the ulna when refracture is of concern.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106717"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598043","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 forefoot biasing footwear on Achilles tendon and ankle biomechanics in individuals with Achilles tendinopathy","authors":"Sara M. Magdziarz,&nbsp;Molly S. Pacha,&nbsp;David M. Williams,&nbsp;Ruth L. Chimenti,&nbsp;Jason M. Wilken","doi":"10.1016/j.clinbiomech.2025.106684","DOIUrl":"10.1016/j.clinbiomech.2025.106684","url":null,"abstract":"<div><h3>Background</h3><div>Exercise-based rehabilitation is the standard conservative treatment for Achilles tendinopathy, however, symptoms often persist post-treatment. Forefoot biasing footwear may augment rehabilitation by influencing tendon loading and ankle kinematics. This study aims to determine its effect on Achilles tendon loading and ankle kinematics in individuals with Achilles tendinopathy.</div></div><div><h3>Methods</h3><div>Fifteen participants with chronic symptomatic midportion Achilles tendinopathy (7 female; mean(SD) age: 39.5(6.4) years) performed seven commonly prescribed activities wearing only athletic shoes and with forefoot biasing footwear, in randomized order. Activities included walking and unilateral and bilateral heel raises and hops. Kinematics and kinetics were collected using computerized motion analysis. Achilles tendon force was estimated by dividing the ankle moment by an approximated tendon moment arm. Non-parametric statistical analyses assessed differences between footwear conditions (α = 0.05).</div></div><div><h3>Findings</h3><div>Forefoot biasing footwear significantly increased peak ankle dorsiflexion angle (range: 1.8–5.4 degrees) in all activities except unilateral hop, while reducing peak ankle plantarflexion angle (6.2–15.5 degrees) and ankle range of motion (1.8–10.6 degrees) with moderate to large effect sizes. Achilles tendon force impulse increased significantly (12 %–87 %) with forefoot biasing footwear in the five lowest peak loading activities, with large effect sizes. Walking showed consistent significant differences in tendon loading between footwear conditions (<em>P</em> ≤ 0.020). No significant differences in loading were observed between conditions for bilateral hopping (<em>P</em> ≥ 0.078).</div></div><div><h3>Interpretation</h3><div>Forefoot biasing footwear can modulate ankle angles and Achilles tendon loading in individuals with midportion Achilles tendinopathy and may be useful for progressing loading prior to introducing more advanced movements.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106684"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551475","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 margin of stability as a measure of balance for people with multiple sclerosis","authors":"Olivia F. Simpson ,&nbsp;Dimitar Stanev ,&nbsp;Joe Pitt-Francis ,&nbsp;Mattia Zanon ,&nbsp;Mike D. Rinderknecht ,&nbsp;Amy B. Zavatsky","doi":"10.1016/j.clinbiomech.2025.106696","DOIUrl":"10.1016/j.clinbiomech.2025.106696","url":null,"abstract":"<div><h3>Background</h3><div>Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system, which can impact postural control. The Margin of Stability (MoS) is a biomechanical measure of how close someone is to falling without corrective action. Walking MoS has been extensively studied in people with MS (PwMS), while standing MoS is less studied. This work explores the relationship between the standing MoS and clinical measures, identifying a standing MoS summary feature that quantifies the level of balance impairment due to MS, across a range of stances.</div></div><div><h3>Methods</h3><div>In an observational study, participants stood in five stances, with different bases of support, each for 30 s. Standing MoS was calculated using motion capture data and compared with established clinical scales.</div></div><div><h3>Findings</h3><div>Ninety-six PwMS (EDSS: 1.5–6.5) completed at least one stance. The range and standard deviation of the Global (two-dimensional) standing MoS were significantly correlated (<em>p</em> &lt; 0.05) with MS-related impairment (EDSS) in all but one stance. Correlations were also found between the Standing MoS and patient-reported outcomes: ABC and MSWS-12. The range of Global MoS demonstrated strong known-group validity (<em>p</em> &lt; 0.001), distinguishing mild from moderate and severe MS across all stances.</div></div><div><h3>Interpretation</h3><div>There are strong correlations between the standing MoS and established clinical scales. MSWS-12 has the weakest correlations as it is designed to capture information relevant to walking, not standing. The range of the Global MoS should be used for standing MoS studies involving PwMS. The standing MoS could be explored for use as a trial outcome measure or clinical scale.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106696"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508023","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":"Fluted stem designs enhance surgical precision and primary stability in cementless revision hip arthroplasty – A cadaver study","authors":"Julius M. Boettcher ,&nbsp;Kay Sellenschloh ,&nbsp;Ana Cruz Pardos ,&nbsp;Gerd Huber ,&nbsp;Benjamin Ondruschka ,&nbsp;Michael M. Morlock","doi":"10.1016/j.clinbiomech.2025.106723","DOIUrl":"10.1016/j.clinbiomech.2025.106723","url":null,"abstract":"<div><h3>Background</h3><div>Cortical contact of the stem is a key determinant for primary stability in cementless revision hip arthroplasty. This matched-pair cadaveric study evaluated whether implant designs that increase cortical contact improve primary fixation of cementless revision stems</div></div><div><h3>Methods</h3><div>Ten paired femora received either a tapered monoblock RECLAIM™ stem with advanced spline (RAS) geometry or an identically sized prototype solid stem. Axial seating and rotation were recorded using dynamic image correlation during implantation. Specimens were cyclically loaded up to 200 % body weight, after which torque-to-failure was measured</div></div><div><h3>Findings</h3><div>Both designs showed mean micromotion &lt;50 μm during cyclic loading, consistently favourable for osseointegration. However, solid stems rotated more during implantation than RAS stems (3.6 ± 5.0° vs. 0.5 ± 0.6°, <em>p</em> = 0.088). The cortical contact area of the solid stems was 43.6 % larger than RAS stems (<em>p</em> &lt; 0.001) without an impact on superior fixation: Axial subsidence and rotation during cyclic loading did not differ significantly between the designs but two solid-stem specimens fractured under high loading. Torque-to-failure of the RAS stems was 38.7 ± 7.5 nm, exceeding that of solid stems by 24.3 % (<em>p</em> = 0.032)</div></div><div><h3>Interpretation</h3><div>These findings suggest that maximising circumferential contact by implant design alone cannot compensate for irregularities of the femoral canal. Whereas solid stems wedge firmly only at the cost of positioning accuracy and increased fracture risk, the thin splines of the RAS design engage the cortex progressively, guide the implant to the planned depth, and augment torsional resistance without excessive press-fit. Tapered stems with cortex-indenting splines improve primary stability in cementless revision hip arthroplasty more effectively than increasing contact area alone.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106723"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623497","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":"Association of Transversus Abdominis with gait speed in patients with hip osteoarthritis","authors":"Hideki Suzuki ,&nbsp;Eiki Tsushima ,&nbsp;Tatsuya Nakanowatari ,&nbsp;Yoko Ono ,&nbsp;Yumetaka Shinden ,&nbsp;Shigeo Aota ,&nbsp;Kazuo Ouchi ,&nbsp;Tetsuo Hayashi","doi":"10.1016/j.clinbiomech.2025.106690","DOIUrl":"10.1016/j.clinbiomech.2025.106690","url":null,"abstract":"<div><h3>Background</h3><div>Gait speed is a major determinant of daily function and quality of life in hip osteoarthritis, yet evidence on how trunk muscles are associated with gait is scarce. We investigated factors associated with gait speed in hip osteoarthritis, focusing on the transversus abdominis (TrA).</div></div><div><h3>Methods</h3><div>Forty-nine women with hip osteoarthritis (64.2 ± 7.1 years) awaiting first unilateral total hip arthroplasty were enrolled. On the day before surgery, physical condition and function, including gait speed, gait pain, lower-limb strength, and TrA contraction ratio, were evaluated. To clarify which physical and functional variables are associated with gait speed, we entered gait pain, hip and knee-strength, TrA contraction ratio, age, Japan Orthopaedic Association stage for the hip on the unaffected side, leg length discrepancy and cane use during gait into a stepwise multiple-regression model with gait speed as the outcome.</div></div><div><h3>Findings</h3><div>Stepwise regression showed that hip abductor strength on the unaffected side, cane use during gait, age, and the TrA contraction ratio were independently associated with gait speed (overall <em>p</em> &lt; 0.001). The model explained 46 % of the variance in gait speed (<em>R</em>² = 0.463) and showed acceptable predictive accuracy (PRESS = 3.555; predicted <em>R</em>² = 0.347; large effect size <em>f</em>² = 0.862).</div></div><div><h3>Interpretation</h3><div>Beyond lower-limb strength, cane use during gait and age, our findings show that TrA function is also associated with gait speed in hip osteoarthritis. This study demonstrates that TrA function is an independent correlate of gait speed in hip osteoarthritis and should be routinely assessed in clinical practice.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106690"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524930","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 models of lumbar spine degeneration: Methods, challenges, and clinical promise","authors":"Hamed Hani ,&nbsp;Gregory G. Knapik ,&nbsp;Eric C. Bourekas ,&nbsp;William S. Marras","doi":"10.1016/j.clinbiomech.2025.106675","DOIUrl":"10.1016/j.clinbiomech.2025.106675","url":null,"abstract":"<div><h3>Background:</h3><div>Lumbar disc degeneration is a leading cause of disability worldwide and a major contributor to low back pain. Biomechanical models have emerged as powerful tools to investigate the structural and mechanical changes associated with disc degeneration, offering insights that are difficult to obtain in vivo.</div></div><div><h3>Methods:</h3><div>This narrative review examines the progression of biomechanical modeling efforts in lumbar disc degeneration over the past decade. We reviewed studies from 2013 to 2024, focusing on both finite element and musculoskeletal modeling approaches. Key developments in model personalization, tissue degeneration simulation, and validation techniques were analyzed to assess their contribution to understanding spinal mechanics in degenerative states.</div></div><div><h3>Findings:</h3><div>Recent advancements have enabled more accurate representations of intervertebral disc pathology, incorporating subject-specific imaging, detailed tissue behavior, and complex loading scenarios. While finite element models have improved in capturing disc-level mechanical changes, musculoskeletal models have advanced in simulating whole-body dynamics and compensatory mechanisms. However, gaps remain in integrating these approaches and validating models against in vivo measurements. Few studies have directly linked modeling outcomes with clinical decision-making or patient-specific interventions.</div></div><div><h3>Interpretation:</h3><div>Biomechanical models have significantly improved our understanding of lumbar disc degeneration and its mechanical consequences. Future efforts should prioritize multimodal validation, integration of imaging and motion capture data, and development of clinically actionable models. Advancing these tools may enable more personalized and predictive approaches to spine care and support novel therapeutic strategies.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"130 ","pages":"Article 106675"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410428","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}