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The Comprehensive
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Biomechanics
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CONTENTS
HUMAN MOVEMENT...........................104
JIM RICHARDS 12 BIOMECHANICS OF ORTHOTIC
MANAGEMENT.....................................282
6 INVERSE DYNAMICS THEORY...............124 JIM RICHARDS ■ AOIFE HEALY ■
JIM RICHARDS NACHIAPPAN CHOCKALINGAM
v
EDITOR
vi
CONTRIBUTORS
vii
viii Contributors
DOMINIC THEWLIS BSC (HONS), PHD NATALIE VANICEK BSC (HONS), MSC,
Associate Professor of Biomechanics and NHMRC PGCHE, PHD
R.D. Wright Career Development Fellow at Centre Reader in Biomechanics focusing on preventing falls
for Orthopaedic and Trauma Research, University and improving musculoskeletal function at the
of Adelaide, Australia University of Hull, UK
For Jackie, Imogen and Joe
ACKNOWLEDGEMENTS
I owe an enormous debt of gratitude to all my col- of 72. Carlo has been an inspiration to me and to
leagues and students past and present. Particularly I countless others. Throughout his life he challenged the
wish to thank my contributors for their tireless work status quo which led to significant breakthroughs on
and contributions. the frontiers of neuromuscular control, signal process-
I would also like to take this opportunity to say ing and EMG sensor technology. This is an example to
farewell to my friend and mentor Professor Carlo John us all. Carlo you have left an unrivalled legacy in your
De Luca who passed away on July 20, 2016 at the age field, you will be missed.
x
INTRODUCTION
Over the years many clinicians have commented about This book covers the concepts and theory necessary
the increase in the need for what is described as Evi- to understand the nature of biomechanical measure-
dence Based Practice or Evidenced Based Medicine. ments, and the methods available to collect, analyse,
The users’ guides to evidence-based medicine (Journal and interpret biomechanical data in a clinically
of the American Medical Association, 1992) states that; meaningful way. This includes: the mathematical and
mechanical concepts necessary for the understand-
■ The understanding of basic mechanisms of ing of the musculoskeletal system and the interpreta-
disease are not sufficient guides for clinical tion of biomechanical measurements, the variety of
practice alone. methods available for biomechanical measurement,
■ Systematically recorded observations and repro- and the biomechanics of conservative management
ducible measurements are needed to study the of musculoskeletal and neurological pathologies. This
effectiveness of clinical practice. book also covers the biomechanics of prosthetics and
Two of the challenges in clinical practice are, the orthoses and the biomechanics of common move-
reproducibility of measurements of effectiveness and ment tasks used in clinical assessment. This therefore
the clinical relevance of the measures made. Two should allow undergraduate and postgraduate allied
questions that have become commonplace in clinical health professionals to advance their biomechanical
research in the last few years are: knowledge and understanding in a way relevant to
both training and clinical practice.
■ What are Minimal Clinical Important Differ- A substantial interactive virtual learning environ-
ences (MCIDs)? These can be defined as smallest ment and teaching resource runs parallel with this
measureable differences between the patient and book. The virtual learning environment contains
a defined “normal”. lessons relating to the material covered in the paper
■ What are Minimal Clinically Important Changes text book. This also includes many interactive ques-
(MCICs)? These can be defined as the small- tions to help the learner determine the level of their
est change in score in the domain of interest understanding as they proceed. This virtual learning
due to a treatment which patients perceive as environment “course” is highly illustrated and con-
beneficial. tains animations which describe the mathematical
So the questions that need to be asked of biome- and mechanical concepts needed to understand bio-
chanics are: mechanics. These animations demonstrate the theory
covered, and allow the user to control animations of
■ Can biomechanics offer new and sensitive meas- the various clinical case studies included in the text.
ures of assessment? This aims to provide a stream of online information
■ Can biomechanics assess the effectiveness of on biomechanics in a modular format for teaching
different treatments? and learning, and builds understanding and appli-
■ Can biomechanics offer immediate, informed cation of biomechanics at a steady pace. This struc-
and direct feedback to clinical practice? tured approach is designed to act as a companion to
xi
xii Introduction
undergraduate and postgraduate courses featuring more advanced methods of analysing the function
clinical biomechanics. of walking.
Chapter 10: Electromyography and isometric testing are also covered and how these
Chapter 10 covers the nature of an electromyographic can relate to different aspects of muscle function and
(EMG) signal and the different methods of measuring physiological cost.
muscle activity using EMG. This includes the setup
and use of EMG and considers standard data process- Chapter 12: Biomechanics of Orthotic Management
ing techniques used in EMG and which factors affect Chapter 12 covers the biomechanics of orthotic man-
the quality of the EMG signal. In addition, this chapter agement of the lower limb. This includes the theoretical
also covers some more recent advancements in EMG mechanics of indirect and direct orthotic management
data collection and processing that allows individual and clinical case study data of the use of the devices
motor units to be measured. covered.
AAR: Active Angle Reproduction coronal plane: Frame of reference for the body –
accelerometer: electro-mechanical devices which viewed from the front (see frontal plane)
measure acceleration
AFO: Ankle Foot Orthosis direct linear transformation (dlt): The common
ambulation: Walking mathematical approach to constructing the three-
angle of gait: The angle of foot orientation away dimensional location of an object from multiple
from the line of progression two-dimensional images
angular displacement: The rotational component of dorsiflexion: To flex backward, as in the upward
a body’s motion bending of the fingers, wrist, foot, or toes
angular velocity: The rate of change of angular double support: The stance phase of one limb over-
displacement laps the stance phase of the contralateral limb creat-
anterior: The front of the body or a part facing toward ing a period during which both feet are in contact
the front with the ground
anthropometry: The study of proportions and prop-
erties of body segments eccentric: Where the muscle lengthens under load
electrogoniometer: A device for measuring changes
biomechanics: The study of mechanical laws and in joint angle over time using either a potentiometer
their application to living organisms, especially the or strain gauge wire
human body and its movement Em: Energy expenditure per metre (J/kg/m)
EMG or electromyography: The study of the electri-
CAST: Calibrated Anatomical System Technique cal activity of muscles and muscle groups
cadence: The number of steps taken over a period of Es: Instantaneous energy of any body segment
time, usually steps per minute Ew: Energy expenditure per minute (J/kg/min)
cardan sequence: Ways of defining one local (LCS) extension: A movement which increases the angle
or segment coordinate system (SCS) relative to between two connecting bones
another
centre of mass: The midpoint or centre of the mass filtering: The process of manipulating the frequencies
of a body or object of a signal through analogue or digital processing
centroid: The two-dimensional coordinates of the flexion: A movement which decreases the angle
centre of an area between two connecting bones
clusters: Rigid plate with four or more reflective Foot angle: The angle of foot orientation away from
markers the line of progression
CKC: Closed Kinetic Chain force platform: A device for measuring the forces
concentric: Where the muscle shortens as it contracts acting beneath the feet during walking
under load force twitch: The force generated by the contraction
coplanar: Lying or acting in the same plane of a single motor unit
xiv
Glossary of Terms xv
frontal plane: Frame of reference for the body – LCS: local coordinate system
viewed from the front linear displacement: Distance moved in a particular
direction
g: Acceleration due to gravity linear velocity: Speed at which an object is moving in
gait: The manner of walking a particular direction
gait analysis: The study of locomotion of humans loading response: Period immediately following the
and animals initial contact of the foot
gait initiation: To start walking
GCS: Global coordinate system markers: small reflective balls that are used to track
global frame of reference: A set of orthogonal movement
axes, one of which is parallel with the field of mid stance: The period from the lift of the contralat-
gravity eral foot from the ground to a position in which the
goniometer: a simple hand-held device for measur- body is directly over the stance foot
ing joint angles mid swing: This is the period of swing phase imme-
GRF or ground reaction force: The reaction force diately following maximum knee flexion to the time
as a result of the body hitting or resting on the when the tibia is in a vertical position
ground Monopodal: Standing on one leg
gyroscopes: electro-mechanical devices which meas- moment of inertia: The rotational inertial properties
ure angular velocity of an object
motion or movement analysis: A technique of
habituation: Becoming accustomed recording and studying movement patterns of
hemiplegia: Paralysis of one side of the body animals and objects
hs: Height of the centre of mass above the datum motoneuron: neurons that originate in the spinal
cord
IMU: inertial measurement unit motor unit (MU): functional unit of muscles com-
impulse force: Area under a force-time curve prising of a single motoneuron and all the fibers
instantaneous power: Power at a particular moment innervated by the motoneuron.
in time motor unit action potential (MUAP): response of
Is: Moment of inertia about the proximal joint all single muscle fibre action potentials belonging to
Isometric: Where the joint angle and muscle length one motor unit
do not change during contraction ms: Segment mass
Isotonic contraction: Where the tension in the
muscle remains constant despite a change in muscle non-collinear: Points that do not lie in a straight
length line
JCS: Joint coordinate system obliquity: Pelvic movement when viewed in the
coronal plane
KAFO: Knee Ankle Foot Orthosis OKC: Open Kinetic Chain
KAM: Knee Adduction Moment
kinematics: The study of the motion of the body PAR: Passive Angle Reproduction
without regard to the forces acting to produce the pascals: Units of pressure
motion pedotti diagram: Ground Reaction Force vector
kinetic energy: The energy associated with motion, diagram
both angular and linear plantarflexion: The downward bending of the foot
kinetics: The study of the forces that produce, stop, or toes
or modify motions of the body posterior: The back of the body or a part placed in
ks: Radius of gyration of body segment the back of the body
xvi Glossary of Terms
potential energy: The energy associated with the ver- step length: Distance between two consecutive heel
tical position of the centre of mass of an object strikes
power: The rate of performing work step time: Time between two consecutive heel strikes
pressure: force divided by area stride length: Distance between two consecutive heel
pressure time integral: area under the pressure-time strikes by the same foot
graph stride time: Time between two consecutive heel
preswing: The period immediately before the lifting strikes by the same foot
off of the stance foot supination: To rotate the foot by adduction and
pronation: To rotate the foot by abduction and ever- inversion so that the outer edge of the sole bears the
sion so that the inner edge of the sole bears the body’s weight
body’s weight superposition: when one wave is superimposed ‘sat
on top of ’ another
radius of gyration: This is a fictitious distribution of swing phase: Period when a foot is not in contact
the mass around the centre of mass with the ground
range of motion: The angular excursion through
which a limb moves temporal: Timing
rehabilitation: Restoring a patient or a body part to total support: The total time the body is supported
normal or near normal after a disease or injury by one leg during one complete gait cycle
relative velocity: A measure of velocity in terms of translation: Movement in a particular direction
the height of the individual. The units reported are transverse plane: Frame of reference for the body –
statures/s viewed from above
RMS: Root Mean Squared TTDPM: Threshold to detect passive motion
rs: Position of the centre of mass from the proximal
joint vs: absolute velocity of the centre of mass
varus/valgus: Angle of the ankle or knee joint viewed
SACH: A type of prosthetic foot with a solid ankle in the coronal plane
and a cushioned heel
sagittal plane: Frame of reference for the body – work done: product of a force and displacement
viewed from the side walk mat and walkway: A device to measure the
SCS: Segment coordinate system temporal and spatial parameters of gait
single support: The period during the gait cycle
when one foot is in contact with the ground x , y and z : Linear velocities in the x, y, and z
SNR: Signal-to-noise ratio directions
spatial: Distance
stance phase: The period when a foot is contact with ωs: Absolute angular velocity of segment
the ground
Section 1 MECHANICS AND
BIOMECHANICS THEORY
1 MATHS AND MECHANICS
JIM RICHARDS
T his chapter covers the key terminology, basic mathematics and mechanics
needed to understand the much more complicated problem of the mechanics of
the human body. It illustrates how problems may be broken down into separate
parts and shows the techniques used for the more advanced biomechanical prob-
lems covered later.
Toinen kirja
Sopimaton kokous
1.
Tultiin luostariin
Sattui tulemaan kaunis, lämmin ja kirkas päivä. Oli elokuun loppu.
Kohtauksen luostarinvanhimman luona oli määrä tapahtua kohta
päiväjumalanpalveluksen jälkeen, noin puoli kahdentoista aikaan.
Meidän luostarivieraamme eivät kuitenkaan saapuneet
jumalanpalvelukseen, vaan tulivat juuri sen päättyessä. He tulivat
kaksissa ajopeleissä. Ensimmäisissä ajopeleissä, komeissa
vaunuissa, joita veti kaksi kallisarvoista hevosta, saapui Pjotr
Aleksandrovitš Miusov mukanaan kaukainen sukulaisensa, hyvin
nuori, noin kahdenkymmenen vuoden ikäinen mies Pjotr Fomitš
Kalganov. Tämä nuori mies valmistautui yliopistoon, mutta Miusov,
jonka luona hän jostakin syystä toistaiseksi asui, houkutteli häntä
mukaansa ulkomaille, Zürichiin tai Jenaan, jotta hän siellä menisi
yliopistoon ja suorittaisi opintonsa. Nuorukainen ei vielä ollut tehnyt
päätöstään. Hän oli miettiväinen ja hajamielisen näköinen. Hänen
kasvonsa olivat miellyttävät, ruumiinrakenne vahva ja hän oli
jokseenkin pitkä. Hänen katseensa oli omituisen liikkumaton: kuten
kaikki hyvin hajamieliset ihmiset hän saattoi katsella jotakuta kauan
ja katsettaan pois kääntämättä eikä kuitenkaan nähnyt sitä, johon
katsoi. Hän oli vaitelias ja jonkin verran kömpelö, mutta saattoi
tapahtua — ei kuitenkaan muulloin kuin hänen ollessaan
kahdenkesken jonkun kanssa — että hän yht'äkkiä tuli hyvin
puheliaaksi, rajuksi ja naurunhaluiseksi ja nauroi mene tiedä mille
kaikelle. Mutta hänen innostuksensa sammui yhtä nopeasti ja äkkiä
kuin oli syntynytkin. Hän oli aina hyvin, jopa hienosti puettu. Hänellä
oli jonkin verran aivan omaa omaisuutta ja hän odotti saavansa vielä
paljon enemmän lisää. Aljoša ja hän olivat ystäviä.
— Kuinka minä en tulisi? Mitä varten minä sitten olen tänne tullut,
jos en nähdäkseni täällä kaikki heidän tapansa? Yksi seikka minua
vain vaivaa, nimittäin se, että olen nyt teidän seurassanne, Fjodor
Pavlovitš…
— Jos niin on, niin minä menen isä igumenin luo, menen sillävälin
suoraan isä igumenin luo, — alkoi tilanomistaja Maksimov sipistä.