Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position |
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| Authors: | Louis M. Ferreira James A. Johnson Graham J.W. King |
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| Affiliation: | 1. Bioengineering Research Laboratory, The Hand and Upper Limb Center, St. Joseph’s Health Care London, 268 Grosvenor Street, London, Ontario, Canada N6A 4L6;2. Department of Surgery, The University of Western Ontario, London, Ontario, Canada;3. Mechanical and Materials Engineering, The University of Western Ontario, London, Ontario, Canada;4. Medical Biophysics, The University of Western Ontario, London, Ontario, Canada;1. Department of Orthopedic Surgery and Traumatology, Holbæk Hospital, Holbæk, Denmark;2. Orthopedic Research Unit, Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark;3. Department of Forensic Medicine, Laboratory of Biological Anthropology, University of Copenhagen, Copenhagen, Denmark;4. Department of Radiology, Glostrup Hospital, Glostrup, Denmark;5. Department of Clinical Research, University of Southern Denmark, Odense, Denmark;1. Centre hospitalier de Bicêtre, AP–HP, 94270 Paris, France;2. Université Paris-Sud, 91405 Orsay, France;3. Service de chirurgie orthopédique, 78, rue du General-Leclerc, 94270 Le Kremlin-Bicêtre, France;4. Département d’anesthésie-réanimation, 78, rue du General-Leclerc, 94270 Le Kremlin-Bicêtre, France;5. Laboratoire de recherche en mécanique appliquée, université de Rennes 1, IUT de Rennes, site Baulieu, rue du Clos-Courtel, BP 1144, 35014 Rennes, France;1. Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States;2. Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States;3. Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States;4. Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, United States |
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| Abstract: | In-vitro simulation of active joint motion is useful to evaluate rehabilitation protocols and surgical procedures in the laboratory prior to their application in patients. To date, simulated active elbow flexion has been reliably achieved and well established only in the dependent position (humerus vertical with hand down). We have developed and evaluated the performance of a new elbow motion simulator capable of active flexion in the dependent, varus, valgus and horizontal positions. Muscle loading and motion control were achieved via a combination of motors and actuators attached to relevant tendons. Simulated active flexion was compared to passive flexion in terms of repeatability, motion pathways and joint laxity. The joint kinematics of active flexion were significantly more repeatable than passive flexion (p<0.05). Active flexion reduced varus–valgus joint laxity by 29% (supinated p<0.05) and 26% (pronated p<0.05) compared to passive flexion. Greater repeatability of simulated active flexion suggests that this mode of in-vitro testing should increase statistical power and decrease required sample sizes. |
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