A Phase-Dependent Hypothesis for Locomotor Functions of Human Foot Complex

The human foot is a very complex structure comprising numerous bones, muscles, ligaments and synovial joints. As the only component in contact with the ground, the foot complex delivers a variety of biomechanical functions during human locomotion, e.g. body support and propulsion, stability maintenance and impact absorption. These need the human foot to be rigid and damped to transmit ground reaction forces to the upper body and maintain body stability, and also to be compliant and resilient to moderate risky impacts and save energy. How does the human foot achieve these apparent conflicting functions？ In this study, we propose a phase-dependent hypothesis for the overall locomotor functions of the human foot complex based on in-vivo measurements of human natural gait and simulation results of a mathematical foot model. We propse that foot functions are highly dependent on gait phase, which is a major characteristics of human locomotion. In early stance just after heel strike, the foot mainly works as a shock absorber by moderating high impacts using the viscouselastic heel pad in both vertical and horizontal directions. In mid-stance phase （-80% of stance phase）, the foot complex can be considered as a springy rocker, reserving external mechanical work using the foot arch whilst moving ground contact point forward along a curved path to maintain body stability. In late stance after heel off, the foot complex mainly serves as a force modulator like a gear box, modulating effective mechanical advantages of ankle plantiflexor muscles using metatarsal-phalangeal joints. A sound under- standing of how diverse functions are implemented in a simple foot segment during human locomotion might be useful to gain insight into the overall foot locomotor functions and hence to facilitate clinical diagnosis, rehabilitation product design and humanoid robot development.     

Segmental Kinematic Coupling of the Human Spinal Column during Locomotion

As one of the most important daily motor activities, human locomotion has been investigated intensively in recent decades. The locomotor functions and mechanics of human lower limbs have become relatively well understood. However, so far our understanding of the motions and functional contributions of the human spine during locomotion is still very poor and simultaneous in-vivo limb and spinal column motion data are scarce. The objective of this study is to investigate the delicate in-vivo kinematic coupling between different functional regions of the human spinal column during locomotion as a stepping stone to explore the locomotor function of the human spine complex. A novel infrared reflective marker cluster system was constrncted using stereophotogrammetry techniques to record the 3D in-vivo geometric shape of the spinal column and the segmental position and orientation of each functional spinal region simultaneously. Gait measurements of normal walking were conducted. The preliminary results show that the spinal column shape changes periodically in the frontal plane during locomotion. The segmental motions of different spinal functional regions appear to be strongly coupled, indicating some synergistic strategy may be employed by the human spinal column to facilitate locomotion. In contrast to traditional medical imaging-based methods, the proposed technique can be used to investigate the dynamic characteristics of the spinal column, hence providing more insight into the functional biomechanics of the human spine.     

A Dynamic Finite Element Analysis of Human Foot Complex in the Sagittal Plane during Level Walking

The objective of this study is to develop a computational framework for investigating the dynamic behavior and the internal loading conditions of the human foot complex during locomotion. A subject-specific dynamic finite element model in the sagittal plane was constructed based on anatomical structures segmented from medical CT scan images. Three-dimensional gait measurements were conducted to support and validate the model. Ankle joint forces and moment derived from gait measurements were used to drive the model. Explicit finite element simulations were conducted, covering the entire stance phase from heel-strike impact to toe-off. The predicted ground reaction forces, center of pressure, foot bone motions and plantar surface pressure showed reasonably good agreement with the gait measurement data over most of the stance phase. The prediction discrepancies can be explained by the assumptions and limitations of the model. Our analysis showed that a dynamic FE simulation can improve the prediction accuracy in the peak plantar pressures at some parts of the foot complex by 10%–33% compared to a quasi-static FE simulation. However, to simplify the costly explicit FE simulation, the proposed model is confined only to the sagittal plane and has a simplified representation of foot structure. The dynamic finite element foot model proposed in this study would provide a useful tool for future extension to a fully muscle-driven dynamic three-dimensional model with detailed representation of all major anatomical structures, in order to investigate the structural dynamics of the human foot musculoskeletal system during normal or even pathological functioning.     

Biomechanical Analysis of the Human Finger Extensor Mechanism during Isometric Pressing

This study investigated the effects of the finger extensor mechanism on the bone-to-bone contact forces at the interphalangeal and metacarpal joints and also on the forces in the intrinsic and extrinsic muscles during finger pressing. This was done with finger postures ranging from very flexed to fully extended. The role of the finger extensor mechanism was investigated by using two alternative finger models, one which omitted the extensor mechanism and another which included it. A six-camera three-dimensional motion analysis system was used to capture the finger posture during maximum voluntary isometric pressing. The fingertip loads were recorded simultaneously using a force plate system. Two three-dimensional biomechanical finger models, a minimal model without extensor mechanism and a full model with extensor mechanism (tendon network), were used to calculate the joint bone-to-bone contact forces and the extrinsic and intrinsic muscle forces. If the full model is assumed to be realistic, then the results suggest some useful biomechanical advantages provided by the tendon network of the extensor mechanism. It was found that the forces in the intrinsic muscles (interosseus group and lumbrical) are significantly reduced by 22% to 61% due to the action of the extensor mechanism, with the greatest reductions in more flexed postures. The bone-to-bone contact force at the MCP joint is reduced by 10% to 41%. This suggests that the extensor mechanism may help to reduce the risk of injury at the finger joints and also to moderate the forces in intrinsic muscles. These apparent biomechanical advantages may be a result of the extensor mechanism''s distinctive interconnected fibrous structure, through which the contraction of the intrinsic muscles as flexors of the MCP joint can generate extensions at the DIP and PIP joints.     

The Versatility of Human Locomotion

Human locomotion was studied for 160 societies through the use of early travel accounts, missionaries' reports, and the ethnographic literature. As a result of the value Western society has placed on a sedentary way of life, and the consequent devaluation of movement, the common "striding gait" of humans has taken on a kind of misplaced concreteness. Humans facultatively employ a number of locomotor patterns besides the habitual bipedal gait: long-distance running, climbing, leaping, crawling, swimming, and skiing (the latter two are not dealt with in this paper). Human locomotion, like that of animals, is an analogous rather than a univocal concept, admitting great variation, plasticity, and subtle differences in gait, style, speed, and endurance. These multiple concepts have important implications for the construction of models of the evolution of hominid bipedalism.     

Complex Study of Drosophila Mutants in the agnostic Locus: A Model for Coupling Chromosomal Architecture and Cognitive Functions

After the devastation of genetics in our country, Academician Leon A. Orbeli has provided an opportunity for the studies on evolutionary conservatism of genes controlling the main properties of the higher nervous activity and conditioning. For the last few years, determination and bioinformatic analysis of genome sequences in the plant, worm, Drosophila, and human genome have revealed, indeed, a high interspecies homology of genes. Studies on Drosophila mutants have shown that components of intracellular signalization systems regulating neuronal functions and gene expression are organized in supramolecular complexes. It has become evident that the chromosomal architecture predetermines the appearance of deletions, duplications, insertions, and translocations and, therefore, plays an important role not only in evolution but also in generating human pathological syndromes with multiple manifestations, including cognitive dysfunctions. There appeared a new approach, comparative genomics, that allows revealing functions of human disease genes on the basis of their sequence homology to the known Drosophila gene with various well-studied mutant phenotypes. For this reason, the Drosophila genes should be saturated with mutant phenotypes, and these are to be studied in comparison with the chromosomal architecture. Our complex behavioral and molecular-genetic study of spontaneous, induced, and P-insertional mutations in the Drosophila agnostic locus and the bioinformatic analyses of genomic sequences has allowed us to assign the locus to the Drosophila genomic scaffold AE003489 from the 11AB X-chromosomal region that contains the CG1848 gene coding for LIM-kinase 1. Mutations, insertions, and deletions in the agnostic locus lead to an increased activity of Ca²⁺/calmodulin-dependent PDE1, resistance to ether, an inactivator of synaptic transmission, impairments of the brain structures, learning and memory defects in conditioned courtship suppression paradigm, alterations in sound production and in structural-functional chromosomal organization. Therefore, the agnostic locus represents a model to study the human Williams syndrome with multiple dysfunctions due to a contiguous deletion in the 7q11.23 spanning 17 genes, among them the gene for LIM-kinase 1 presumed to be responsible for cognitive defects. The Williams syndrome is considered to be a most efficient model to study human cognition, human genome organization, and evolution.     

Convergence in Reflex Pathways from Multiple Cutaneous Nerves Innervating the Foot Depends upon the Number of Rhythmically Active Limbs during Locomotion

Neural output from the locomotor system for each arm and leg influences the spinal motoneuronal pools directly and indirectly through interneuronal (IN) reflex networks. While well documented in other species, less is known about the functions and features of convergence in common IN reflex system from cutaneous afferents innervating different foot regions during remote arm and leg movement in humans. The purpose of the present study was to use spatial facilitation to examine possible convergence in common reflex pathways during rhythmic locomotor limb movements. Cutaneous reflexes were evoked in ipsilateral tibialis anterior muscle by stimulating (in random order) the sural nerve (SUR), the distal tibial nerve (TIB), and combined simultaneous stimulation of both nerves (TIB&SUR). Reflexes were evoked while participants performed rhythmic stepping and arm swinging movement with both arms and the leg contralateral to stimulation (ARM&LEG), with just arm movement (ARM) and with just contralateral leg movement (LEG). Stimulation intensities were just below threshold for evoking early latency (<80 ms to peak) reflexes. For each stimulus condition, rectified EMG signals were averaged while participants held static contractions in the stationary (stimulated) leg. During ARM&LEG movement, amplitudes of cutaneous reflexes evoked by combined TIB&SUR stimulation were significantly larger than simple mathematical summation of the amplitudes evoked by SUR or TIB alone. Interestingly, this extra facilitation seen during combined nerve stimulation was significantly reduced when performing ARM or LEG compared to ARM&LEG. We conclude that locomotor rhythmic limb movement induces excitation of common IN reflex pathways from cutaneous afferents innervating different foot regions. Importantly, activity in this pathway is most facilitated during ARM&LEG movement. These results suggest that transmission in IN reflex pathways is weighted according to the number of limbs directly engaged in human locomotor activity and underscores the importance of arm swing to support neuronal excitability in leg muscles.     

Kinematics of the Coordination of Pointing during Locomotion

In natural motor behaviour arm movements, such as pointing or reaching, often need to be coordinated with locomotion. The underlying coordination patterns are largely unexplored, and require the integration of both rhythmic and discrete movement primitives. For the systematic and controlled study of such coordination patterns we have developed a paradigm that combines locomotion on a treadmill with time-controlled pointing to targets in the three-dimensional space, exploiting a virtual reality setup. Participants had to walk at a constant velocity on a treadmill. Synchronized with specific foot events, visual target stimuli were presented that appeared at different spatial locations in front of them. Participants were asked to reach these stimuli within a short time interval after a “go” signal. We analysed the variability patterns of the most relevant joint angles, as well as the time coupling between the time of pointing and different critical timing events in the foot movements. In addition, we applied a new technique for the extraction of movement primitives from kinematic data based on anechoic demixing. We found a modification of the walking pattern as consequence of the arm movement, as well as a modulation of the duration of the reaching movement in dependence of specific foot events. The extraction of kinematic movement primitives from the joint angle trajectories exploiting the new algorithm revealed the existence of two distinct main components accounting, respectively, for the rhythmic and discrete components of the coordinated movement pattern. Summarizing, our study shows a reciprocal pattern of influences between the coordination patterns of reaching and walking. This pattern might be explained by the dynamic interactions between central pattern generators that initiate rhythmic and discrete movements of the lower and upper limbs, and biomechanical factors such as the dynamic gait stability.     

Genetically-designed Neural Networks for Error Reduction in an Optimized Biomechanical Model of the Human Elbow Joint Complex

A real time dynamic biomechanical model of the human elbow joint has been used as the first step in the process of calculating time varying joint position from the electromyograms (EMGs) of eight muscles crossing the joint. Since calculation of position has a high sensitivity to errors in the model torque calculation, a genetic algorithm (GA) neural network (NN) has been developed for automatic error reduction in the dynamic model. Genetic algorithms are used to design many neural network structures during a preliminary trial effort, and then each network's performance is ranked to choose a trained network that represents the most accurate result. Experimental results from three subjects have shown model error reduction in 84.2% of the data sets from a subject on which the model had been trained, and 52.6% of the data sets from the subjects on which the model had not been trained. Furthermore, the GA networks reduced the error standard deviation across all subjects, showing that progress in error reduction was made evenly across all data sets.     

Locomotion of Fundulus Deep Cells during Gastrulation

SYNOPSIS. Mechanism of locomotion of deep cells of Fundulusheteroclitus was studied in vivo during gastrulation with theaid of time lapse cinemicrography (Nomarski differential interferencecontrast optics), scanning electron microscopy of cells knownto be moving at the time of fixation, and cell culture. Theseare our findings. 1) Deep cells usually move rapidly, at about10–15 µ/min, regardless of whether they move byblebbing or spreading. Evidence suggests that this high speedis associated with weak adhesion of the trailing edge: it remainsrounded, without large retraction fibers, and it advances continuouslywith advance of the leading edge, not sporadically, as it wouldif it adhered strongly. 2) In contrast, when stationary cellsin close contact separate, they remain connected by retractionfibers, suggesting strong punctate adhesions. 3) Locomotionby shortening of a long lobopodium is really a form of spreadingmovement; the tip of a lobopodium always spreads. Also, sincespeed of shortening decreases with continuance, it may dependprimarily on elastic recoil rather than active contraction.4) Fundulus deep cells appear to move in two ways: a) protrusionof blebs, followed by much cytoplasmic flow; b) protrusion oflamellipodia, accompanied by filopodia and frequent cell shortening.5) Filopodia were not found except at the leading edge of aspreading lamellipodium and often spread themselves; perhapsfilopodia and lamellipodia are interconvertible. 6) A lamellipodialmargin may form undulations in vivo that move backward likeruffles in vitro. 7) At all times, whether stationary or moving,the surface of deep cells is smooth, raising unanswered questionsconcerning the source of surface for their rapid protrusiveactivity.     

Laparoscopic Pectopexy: A Biomechanical Analysis

Introduction

Pectopexy, a laparoscopic method for prolapse surgery, showed promising results in recent literature. Further improving this approach by reducing surgical time may decrease complication rates and patient morbidity. Since laparoscopic suturing is a time consuming task, we propose a single suture /mesh ileo-pectineal ligament fixation as opposed to the commonly used continues approach.

Methods

Evaluation was performed on human non-embalmed, fresh cadaver pelves. A total of 33 trials was performed. Eight female pelves with an average age of 75, were used. This resulted in 16 available ligaments. Recorded parameters were ultimate load, displacement at failure and stiffness.

Results

The ultimate load for the mesh + simplified single “interrupted” suture (MIS) group was 35 (± 12) N and 48 (± 7) N for the mesh + continuous suture (MCS) group. There was no significant difference in the ultimate load between both groups (p> 0.05). This was also true for displacement at failure measured at 37 (± 12) mm and 36 (±5) mm respectively. There was also no significant difference in stiffness and failure modes.

Conclusion

Given the data above we must conclude that a continuous suture is not necessary in laparoscopic mesh / ileo-pectineal ligament fixation during pectopexy. Ultimate load and displacement at failure results clearly indicate that a single suture is not inferior to a continuous approach. The use of two single sutures may improve ligamental fixation. However, overall stability should not benefit since the surgical mesh remains the limiting factor.     

A Radiographic Analysis of Major Foot Deformities

Major foot deformities were analyzed using standardized radiographic drawings of the foot in weight-bearing. Specific criteria and a classification of foot deformities by radiographic analysis are presented, utilizing “lining systems” related to the main bones of the hindfoot.The radiographic appearance of the foot is described and analyzed, as are the principal deformities such as varus and valgus heel and forefoot. The prefixes “talipes” and “pes” have been used to signify congenital and acquired deformities, respectively.Specific foot deformities, including talipes equinovarus (clubfoot), pes planovalgus (flatfoot), pes cavus, and metatarsus varus, are analyzed. This method can also be applied in the radiological analysis of any foot deformity.By using this technique, a brief, concise and simplified analysis of foot deformities is available to the student, general practitioner, and specialist.     

Effects of a Foot Placement Constraint on Use of Motor Equivalence during Human Hopping

Humans can robustly locomote over complex terrains even while simultaneously attending to other tasks such as accurate foot placement on the ground. We investigated whether subjects would exploit motor redundancy across the joints of the leg to stabilize overall limb kinematics when presented with a hopping task that constrained foot placement position. Subjects hopped in place on one leg (2.2 Hz) while having to place their foot into one of three target sizes upon landing (0.250, 0.063, 0.010 m²). As takeoff and landing angles are critical to this task performance, we hypothesized smaller target sizes would increase the need to stabilize (i.e., make more consistent) the leg orientation through motor equivalent combinations of segment angles. As it was not critical to the targeting task, we hypothesized no changes for leg length stabilization across target size. With smaller target sizes, we saw total segment angle variance increase due to greater signal-dependent noise associated with an increased activation of leg extensor muscles (medial and lateral gastrocnemius, vastus medialis, vastus lateralis and rectus femoris). At smaller target sizes, more segment angle variance was aligned to kinematic deviations with the goal of maintaining leg orientation trajectory. We also observed a decrease in the variance structure for stabilizing leg length at the smallest target conditions. This trade-off effect is explained by the nearly orthogonal relationship between the two goal-equivalent manifolds for leg length vs. leg orientation stabilization. Our results suggest humans increasingly rely on kinematic redundancy in their legs to achieve robust, consistent locomotion when faced with novel conditions that constrain performance requirements. These principles may generalize to other human locomotor gaits and provide important insights into the control of the legs during human walking and running.