Journal of the Mechanical Behavior of Biomedical Materials

Purpose: Fibrotic remodeling of the uterus, associated with aging, disease, and environmental exposures, alters collagen organization and tissue stiffness, yet how these changes influence organ-level mechanical behavior remains poorly understood. Glutaraldehyde (GA)-induced collagen crosslinking was used as a controlled surrogate for fibrotic remodeling to determine whether image-informed inverse finite element analysis (iFEA), combined with inflation testing and micro-computed tomography (microCT), could detect and quantify the resulting changes in uterine constitutive behavior. Methods: Murine uteri (n = 6 untreated, n = 6 GA-crosslinked) underwent volume-controlled balloon inflation with simultaneous microCT imaging to quantify deformation of the inner and outer wall boundaries for iFEA. Specimen-specific Gasser-Ogden-Holzapfel (GOH) finite element models were optimized by adjusting model parameters to reproduce experimentally measured wall contours throughout inflation. Model performance was evaluated using contour root mean square error (RMSE), and parameter identifiability was assessed through sensitivity analyses. Results: GA treatment significantly increased inflation work, linear stiffness, and maximum inflation resistance (p < 0.001). The iFEA framework accurately reproduced experimental deformation (RMSE < 3%) and revealed significant increases in the estimated GOH parameters C10 (9.2-fold), k1 (2.0-fold), and k2 (2.7-fold), consistent with increased effective tissue stiffness and a shift toward earlier collagen fiber recruitment. Sensitivity analyses demonstrated unique, well-defined minima for all parameter combinations. Conclusion: Image-informed iFEA provides a quantitative framework for relating collagen remodeling to organ-level uterine mechanics through specimen-specific constitutive parameter estimation. This approach establishes a foundation for investigating the mechanical consequences of uterine fibrosis and other remodeling processes.

Introduction: Metastatic spinal lesions substantially alter vertebral mechanical properties and increase fracture risk. Computed tomography (CT) based finite element (FE) models can estimate vertebral strength, but their accuracy depends on how CT derived material properties are represented. This study evaluated the effect of two material grouping strategies on simulated strength and stiffness in metastatic vertebrae. Methods: We compared Adaptive Clustering (AC) with Uniform fixed width grouping in 44 vertebrae from 11 donors (8 osteolytic, 12 osteoblastic, 12 mixed, 12 no observed lesion (NOL)). FE models were generated based on CT scans with 2 to 500 material groups and compared for material mapping error and simulated strength and stiffness. Overall and lesion stratified agreement with experimental measurements was assessed in an exploratory analysis. Results: AC showed significantly lower Young's modulus root mean square error than Uniform (p < 0.05). Simulated strength and stiffness stabilised by 50 material groups. At 50 groups, simulated strength showed moderate correlation with experimental strength overall (R2 = 0.57), strongest in NOL vertebrae (R2 = 0.82) and lower in lesion-bearing vertebrae (R2 = 0.4-0.59). Stiffness showed weaker correlation overall (R2 = 0.27), highest in NOL vertebrae (R2 = 0.48) and negligible in mixed lesions (R2 = 0.007). Bland Altman analyses indicated systematic underestimation of experimental fracture load. Discussion: AC improved material-mapping fidelity, whereas increasing material groups beyond 50 had little influence on simulated strength or stiffness. Numerical stabilisation therefore did not imply experimental accuracy. Lesion stratified findings were exploratory and should be interpreted cautiously because of limited subgroup sizes.

Musculoskeletal symptoms are frequently reported following silicone breast implantation. However, the biological mechanisms linking implant-derived silicone exposure to skeletal muscle alterations remain poorly understood, partly because the biological effects of silicone have long been debated in the context of its biocompatibility. Here, we chemically characterized the low-molecular-weight fraction of the breast implant silicone exposome, readily released from implant gel through gel bleed, and investigated its potential biological consequences using an integrated approach combining analytical chemistry, clinical transcriptomics and histology, and controlled in vitro muscle experiments. Transcriptomic analyses of periprosthetic tissues associated with silicone implant rupture revealed unexpected myogenic and neuromuscular signatures in tissue conventionally regarded as predominantly fibrous, together with alterations in lipid metabolism and transport. These findings were supported by histological evidence of close interactions between periprosthetic tissue and skeletal muscle. Chemical analysis of the implant-gel extract detected linear siloxane L2 and cyclic siloxanes D3-D8, with tentative assignment of D9. In vitro, C2C12 cells exposed to the implant-gel extract showed up to 30% reduced viability and decreased expression of key neuromyogenic genes. Together, these findings provide convergent chemical, clinical, and experimental evidence that low-molecular-weight constituents of the breast implant silicone exposome may constitute a biologically active exposure capable of affecting skeletal muscle. The associated alterations in lipid metabolism and transport further provide a mechanistic framework for investigating the cellular handling and potential tissue distribution of hydrophobic silicone-derived species. These findings position silicone gel bleed as a biologically relevant source of chemical exposure rather than solely a material-integrity phenomenon.

Wound repair is an important mechanism to preserve tissue integrity in organisms after injury. However, why different tissues exhibit different mechanisms to repair wounds is a long-standing question that remains unanswered. In this work, we theoretically explore the role of the purse string, an actomyosin contractile cable used by tissues to close small wounds. Does the tissue 3D geometry influence the efficiency of the purse string in driving wound closure? Using a 3D biophysical model, we study in silico tissues with the same cell volumes but different aspect ratios, ranging from squamous to thick and tall tissues. The model predicts that taller cells are easily deformed by the purse string. In contrast, very squamous cells require a very strong purse string that might demand additional cellular mechanisms to close the gap. These findings establish a theoretical framework to predict the optimal biophysical mechanisms of wound healing in different tissues. Graphical abstractCells of different aspect ratios can be observed in a range of organisms with different function and mechanics. The wound healing efficiency of the purse string increases with the cell aspect ratio in our theoretical exploration. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=135 SRC="FIGDIR/small/743165v1_ufig1.gif" ALT="Figure 1"> View larger version (23K): org.highwire.dtl.DTLVardef@d44ab0org.highwire.dtl.DTLVardef@1737cbaorg.highwire.dtl.DTLVardef@101b5d4org.highwire.dtl.DTLVardef@1487f26_HPS_FORMAT_FIGEXP M_FIG C_FIG

Background: Chronic wounds, ulcers, and lacerations require staged debridement and irrigation to promote healing. However, conventional techniques of debridement, such as surgical, chemical, or autolytic, struggle to fully remove residual necrotic tissue, slough, and unhealthy granulation from wound sites, especially when lodged within wound clefts and cavities, and in wounds with exposed structures. This promotes polymicrobial biofilms, delays wound closure, and causes significant discomfort with increased morbidity. Objective: To demonstrate the feasibility of using an indigenously developed tunable flat-jet hydro-debridement device (presently termed as CleanseJet), a frugal wound debridement system designed for deployment in resource-constrained clinical settings. Methods: An open-label, interventional, single-centre, parallel-group pilot randomized controlled trial was conducted to clinically evaluate an indigenously developed tunable flat-jet hydro-debridement device in patients with wounds of varied aetiology. The device provided adjustable spray impact force and coverage area tailored to wound characteristics. Outcomes were compared with a control group receiving standard wound care alone, with time to complete granulation serving as the primary healing endpoint. Outcomes were compared with a control cohort receiving standard of care alone. Results: The removal of loose devitalized tissue, slough, and biofilms from the wound bed improved the healing, which were monitored using the SINBAD scoring system. No adverse events were reported, supporting the feasibility and safety of CleanseJet. Conclusion: While commercial hydro-debridement systems are effective, they are often costly, rely on disposable components, and require specialized training. In contrast, CleanseJet provides a low-cost, easy-to-use alternative that can be operated with minimal training, making it suitable for broader clinical use without observed adverse effects.

Static force plates (FP) are the gold standard for measuring ground reaction forces (GRF) and computing joint moments through inverse dynamics in gait analysis. However, they are restricted to controlled environments, and the number of steps analyzed is limited by the plates embedded in the floor. To address these limitations, portable solutions such as sensorized insoles, socks, or shoes have emerged. Yet, creating wearable systems capable of measuring three-dimensional GRF in real-world conditions remains challenging. Current sensorized shoes often incorporate thick sensors (up to 2 cm), reducing usability and limiting their application in pathological populations or dynamic tasks like running. This study evaluates the usability of ShokacShoes, a novel sensorized shoe integrating three thin, three-dimensional force sensors, and explores its potential as a Wearable Force Plate (WFP). Eight healthy participants performed slow, natural, and fast walking using two insole configurations. Force and temporal metrics were derived from WFP and FP data. Results indicate that WFP enables accurate step segmentation and detects significant effects of speed and insole type on temporal and force metrics, confirming its reliability under different walking conditions. Comparisons with FP revealed differences in force metrics and signal morphology, though temporal parameters remained consistent. These results are likely due to sensor quantity and positioning. Thereby, ShokacShoes represent a valid solution capable of measuring three-dimensional forces within commercial footwear. Future work will focus on validating the applicability of a new version of ShokacShoes against gold-standard FP in a comprehensive validation study involving diverse real-world scenarios and pathological conditions.

The foreign body response (FBR) is an immune mediated event that occurs with every material implant. The extent of the fibrosis is dependent on many factors including the biomaterial design, tissue location, and host factors such as age, sex, ancestry, diet. There are known clinical outcomes of implants dependent on age and sex, including increased fibrosis and implant failure in aged and female patients. As the population ages, there is a growing need to understand how aging affects the FBR, and how preclinical models can capture this to guide biomaterial design. Here, we investigated how chronic fibrosis in a murine model of the FBR is altered by two biological factors: age and sex. We investigated changes in fibrosis using a volumetric muscle loss (VML) injury model coupled with polycaprolactone (PCL) or polyethylene (PE) microparticle implants. Fibrosis was quantified through gene expression, microscopic analysis of histologic sections, and the corresponding immune response measured via gene expression and flow cytometry data. We found gene expression differences with immune pathways enriched in female mice, and microscopy revealed collagen birefringence area increased in young male mice. Both the innate and adaptive immune response were altered by age and sex via T cell and macrophage phenotype, and the effects of aging differed between sexes. These results reveal both variables contribute to discrepant outcomes in both fibrosis and the local immune response to synthetic material implants. This demonstrates a clear need to understand and account for the influence of biological factors in biomaterial design.

Tumor spheroid mechanics arise from both the mechanical properties of individual cells and the adhesive interactions that organize them into tissues. The relative contribution of these two factors to the bulk mechanical behavior, however, remains difficult to disentangle experimentally. Here, we develop a computational model of micropipette aspiration to compare the mechanical response of isolated cells and multicellular spheroids within a common computational framework. By independently varying single-cell stiffness and cell-cell adhesion, we quantify their effects on aspiration dynamics, effective elastic modulus, and viscoelastic relaxation. Our results show that increasing single-cell stiffness substantially alters the mechanics of isolated cells but has limited influence on the effective elastic modulus of multicellular spheroids. In contrast, changes in cell-cell adhesion produce pronounced effects on spheroid effective elastic modulus. Nevertheless, both parameters increase the retardation time governing the transition from the initial elastic response to long-time viscous deformation. These findings suggest that multicellular elasticity is governed primarily by intercellular mechanical coupling, whereas the dynamical response to applied stress depends jointly on cell-scale mechanics and cell-cell adhesion.

Living myocardial slices (LMS) are a highly relevant ex vivo model for investigating cardiac physiology and disease, as they preserve the native three-dimensional architecture, cellular diversity, and extracellular matrix of the heart. In addition, LMS enable longitudinal functional and molecular analyses. In this study, we established and compared two LMS culture approaches: an air-liquid interface system and a biomimetic culture system. We further examined how different slicing techniques affect tissue quality and longevity within the biomimetic setup. To develop a fibrosis model, LMS were stimulated with transforming growth factor-beta1 (TGF-beta1) and/or exposed to increased mechanical load. Tissue viability was assessed using LIVE/DEAD staining and the MTT assay, while cytotoxicity was evaluated with the LDH-Glo-TM Cytotoxicity assay. Contractile function was measured, and fibrotic remodelling was analysed using RT-qPCR, ELISA, and immunohistochemistry. Our results demonstrate that LMS cultured in the biomimetic system exhibit superior viability, structural integrity, and functional performance compared with those maintained at the air-liquid interface. Mouse LMS could be stably cultured for up to one week in the biomimetic system. Importantly, sample preparation, particularly the slicing method, had a significant impact on tissue quality and culture duration. While TGF-beta1 stimulation alone did not consistently induce fibrosis, combining TGF-beta1 treatment with increased mechanical load led to more pronounced fibrotic remodelling in LMS. These findings highlight the importance of biomechanical cues in modelling cardiac fibrosis ex vivo and support the biomimetic system as a robust platform for functional and disease-relevant studies.

Background: Sacroiliac joint (SIJ) pain is a common musculoskeletal condition among postpartum women due to hormonal, biomechanical, and physiological changes during pregnancy and childbirth. Increased ligament laxity, altered posture, weight gain, and pelvic instability may contribute to sacroiliac joint dysfunction. This condition often leads to pelvic girdle pain, low back pain, and functional limitations that affect daily activities such as walking, sitting, standing, and childcare. Objective: To determine the prevalence of sacroiliac joint pain and assess the level of disability among postpartum females in Sialkot. Materials and Methods: A descriptive cross-sectional study was conducted among 300 postpartum women aged 20-40 years from public and private hospitals in Sialkot. Non-probability convenience sampling approach was employed. Sacroiliac joint pain was assessed using clinical provocation tests including FABER, compression, and distraction tests. Pain intensity was measured using the Numerical Pain Rating Scale (NPRS), and functional disability was evaluated using the Oswestry Disability Index (ODI). Data were analyzed using SPSS version 25. Results: Clinical provocation testing demonstrated positive SIJ pain provocation in 84.0% (n=252) of acute postpartum participants, with severe functional disability observed in 46.0% (n=138). Most women reported moderate pain (74.7%), while 20.7% experienced severe pain. According to the ODI, 46% of participants had severe disability, 37.7% moderate disability, 10.7% minimal disability, and 5.7% were classified as crippled. Conclusion: Sacroiliac joint pain is highly prevalent among postpartum females and is associated with considerable functional disability. Early screening and physiotherapy-based rehabilitation may help reduce pain and improve functional outcomes. Keywords: Sacroiliac joint pain, Postpartum women, Pelvic girdle pain, Functional disability, Oswestry Disability Index.

Tympanic membrane perforations remain a common clinical problem, and although surgical intervention through tympanoplasty achieves high success rates, it is associated with donor-site morbidity, surgical complexity and limited restoration of the native radial and circumferential collagen architecture. In this study, 3D extrusion printing was utilized to create an active scaffold and attempt to promote collagen organization through shear-mediated structural alignment. An alginate-carboxymethyl cellulose (CMC) hydrogel with bovine SIS-dECM was prepared and investigated for its suitability as a bioink alternative to tympanoplasty grafts. The physiochemical, rheological and printability characteristics of the hydrogel were assessed. Successful decellularization was confirmed by histological analysis. The incorporation of the SIS-dECM into the hydrogel led to increased swelling, lower apparent viscosity, yield stress and flow stress while maintaining favourable printability and filament stability. Polarized optical microscopy was also used to study the influence of printing speed on the alignment of collagen to mimic the native tympanic membrane radial collagen architecture. Compared with the cast controls, the printed samples presented stronger birefringence signals. Biological evaluation demonstrated that the 15% dECM hydrogel exhibited the highest live cell area percentage and live/dead ratio after 48 h. In addition, the chick chorioallantoic membrane assay demonstrated that the dECM-containing hydrogels improved vascular density. The findings establish a printable, biologically active dECM bioink capable of generating bulk collagen organization through extrusion printing as a platform for tympanic membrane regeneration.

Objective. A deep learning (DL) model was used to convert smartphone videos of a complete arch implant cast into 3D scans. The aim of current study was to determine if a custom scan body (SB) with geometric features and coating would outperform regular PEEK stock SB in this DL scenario. The DL-derived scan outcomes were compared with those obtained from a conventional splinted open-tray impression and from photogrammetry. Materials and Methods. A maxillary edentulous model with six implants and multi-unit abutment analogs was scanned using four protocols: conventional splinted open-tray impression (CO), photogrammetry (PG; Icam4D), DL using stock SBs (DLS) and DL using custom SBs (DLC). Each protocol was repeated for 10 times. The DL scans were produced from smartphone videos with a high-fidelity, multi-view 3D construction AI model (Neuralangelo). The custom designed SB incorporated geometric features and was fabricated via 3D printing followed by a spray coating. Accuracy (trueness and precision) was assessed using three measurements: Root Mean Square (RMS), linear deviation, and angular deviation. Results. DLC outperformed DLS in both trueness and precision regarding RMS and linear measurements (p<0.001). CO and PG demonstrated the highest RMS and linear trueness, with no significant difference between them (RMS: p=0.93; linear: p=0.663). PG achieved the best precision across RMS, linear and angular measurements. Conclusion. The optimised SB significantly improves the accuracy of DL-based approach for full-arch implant scan comparing to regular PEEK stock scan bodies. While early stage, neural surface reconstruction has potential as a viable option for full-arch implant rehabilitation.

Purpose: Lower-limb prosthesis use involves interacting physical, psychosocial, and device-related outcomes that may not be fully captured by conventional clinical assessment. This study aimed to develop and evaluate a stakeholder-informed framework of outcome domains relevant to meaningful everyday prosthesis use. Materials and Methods: A mixed-methods participatory design comprised a structured synthesis of selected clinically relevant content from five established patient-reported outcome measures; semi-structured interviews and importance and actionability ratings with 18 contributors (12 prosthesis users, four clinicians, and two industrial partners); and integration of the synthesis, qualitative, and rating findings. Interview records were analysed using reflexive thematic analysis, and ratings were analysed descriptively. Results: The resulting framework comprised four interrelated domains: Mobility, Physical Function, Psychosocial Wellbeing, and Prosthesis Experience. Mobility showed the clearest convergence across stakeholder perspectives. Prosthesis users showed the largest importance actionability gap for Prosthesis Experience (4.5 vs 3.0), whereas clinicians showed the largest gap for Psychosocial Wellbeing (5.0 vs 3.0). Interviews highlighted day-to-day variability in prosthesis use and the influence of confidence, fatigue, comfort, environmental conditions, social context, and device usability. Conclusions: Meaningful outcome assessment in prosthetic rehabilitation should extend beyond mobility alone to consider physical function, psychosocial wellbeing, and prosthesis experience within everyday contexts. The proposed framework provides a stakeholder-informed foundation for multidimensional outcome assessment in prosthetic rehabilitation.

Decellularized extracellular matrix (dECM) scaffolds are increasingly used in regenerative medicine, yet the extent to which processed placental dECM retains properties capable of influencing cellular responses remains unclear. This study combines functional cell assays with deep learning-enabled quantitative imaging to determine how dehydrated placental ECM regulates cellular behavior across multiple human cell lineages. Human dermal fibroblasts, cardiac fibroblasts, and osteoblasts were cultured on dehydrated placental ECM or standard cell culture surfaces and assessed for cell attachment, viability, extracellular matrix production, and nuclear morphology. Placental dECM supported attachment and survival across all three cell types, while Pro-Collagen I Alpha 1 secretion varied by cell lineage relative to negative controls. To identify structural responses associated with scaffold culture, an automated imaging pipeline combining Cellpose-based nuclear segmentation with nuclear morphometric analysis was used to quantify nuclear area, eccentricity, and circularity. Quantitative profiling of hundreds of nuclei revealed scaffold-dependent remodeling of nuclear morphology that was not apparent by conventional microscopy. Cells cultured on placental dECM exhibited reduced nuclear area and increased nuclear eccentricity, while cardiac fibroblasts and osteoblasts showed alterations in nuclear circularity. These lineage-dependent morphological responses demonstrate that placental dECM provides more than a permissive substrate for cell attachment and is associated with measurable changes in cellular architecture following processing. Together, these findings support the biological relevance of processed placental dECM as a regenerative biomaterial and demonstrate the utility of quantitative single-cell morphometric analysis for detecting cell-material interactions that may not be apparent through qualitative imaging alone, guiding the rational design of regenerative therapies.

Mechanical properties of biological tissues, driven by passive and active forces, play a vital role in several processes ranging from development to cancer metastasis. However, the dynamical responses of cells in tissues, subject to mechanical deformations such as shear and the associated rheological properties, are not well characterized. Here, we use three-dimensional agent-based models for normal and cancer tissues to investigate their responses to simple shear as a function of cell stiffness and stochastic active forces. In the normal epithelium, with uniform strength of active force, the yield stress as a function of shear rate follows the Herschel-Bulkley form over a range of cell volume fraction. Strikingly, the shear rate dependence and the elasticity-dependent changes in the yield stress fall on master curves upon suitable scaling. To model cancer-like behavior, a certain fraction (Np) of cells was chosen to have enhanced activity and decreased stiffness. As Np increases, the extent of collective cell movement decreases, transitioning from affine (collective) to non-affine (individualistic) movement, a finding that is in accord with imaging experiments. Simulations of a model of a stiff solid tumor, with radius Rs embedded in normal tissue, show that as Rs increases, the yield stress increases. Interestingly, the cells migrate collectively as Rs increases. A Gaussian Mixture Model (GMM) and a mean field theory quantitatively account for the simulation as well as experimental results on cancerous, non-cancerous, and a mixture of these two types. The combined theoretical and experimental study establishes that heterogeneity in stiffness and activity determines non-affine movements in normal and cancer tissues.

Hydrogels have emerged as attractive vaccine delivery platforms because they enable controlled modulation of antigen availability. However, how different hydrogel environments affect the release and functionality of mRNA-loaded lipid nanoparticles (mRNA-LNPs) remains poorly understood. Here, we investigated the release, stability, cellular uptake, and transfection capability of LNPs released from four hydrogel systems representing distinct crosslinking mechanisms: covalently crosslinked poly(ethylene glycol) (PEG), ionically crosslinked alginate, thermoresponsive Poloxamer 407 (P407), and protein-based Matrigel/collagen hydrogels. All hydrogels enabled release of LNPs over days, with kinetics strongly depending on hydrogel composition and polymer concentration. LNPs were quantitatively recovered from all hydrogel types, except from Matrigel/collagen where incomplete matrix dissolution was the limiting step. Lower polymer concentrations generally accelerated nanoparticle release. PEG offered greatest tunability of release kinetics; at the same time the recovery of the LNP-incorporated fluorescent dye DiI was reduced to about 80 %, indicating partial dye leakage. Alginate hydrogels exhibited recovery of DiI below 50 % and broader particle size distributions after release, while P407 hydrogels largely preserved LNP characteristics. Although quantitative recovery from Matrigel/collagen hydrogels was limited, released LNPs remained readily available for cellular uptake. Notably, LNPs released from low- and intermediate-concentration Matrigel/collagen hydrogels achieved approximately 80-90 % of the eGFP expression compared to mRNA-LNP that were not embedded into a hydrogel. Importantly, cellular uptake and transfection experiments demonstrated that all investigated hydrogels released biologically active mRNA-LNPs capable of mediating protein expression. Moreover, our findings show that hydrogel composition is a critical determinant of mRNA-LNP release, stability, and functional delivery. This work provides design principles for the development of hydrogel-based mRNA delivery systems aimed at sustained antigen availability and prolonged vaccine responses. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=156 SRC="FIGDIR/small/741169v1_ufig1.gif" ALT="Figure 1"> View larger version (42K): org.highwire.dtl.DTLVardef@138d9eforg.highwire.dtl.DTLVardef@16c0edaorg.highwire.dtl.DTLVardef@1432dd1org.highwire.dtl.DTLVardef@17511b5_HPS_FORMAT_FIGEXP M_FIG C_FIG

Fingertip friction plays a central role in tactile exploration and object manipulation. During sliding, tangential force depends jointly on the real contact area and the interfacial shear stress, both of which can be influenced by sliding conditions. However, changes in fingertip friction are often interpreted primarily through changes in real contact area, whereas the accompanying changes in interfacial shear stress remain less well characterized. This gap is especially relevant for electrostatic surface haptic displays, which modulate fingertip friction by applying a voltage between the finger and the touch surface. Here, we experimentally quantify the mean interfacial shear stress of a sliding fingertip on an electrostatically actuated touchscreen using simultaneous measurements of tangential force and optically resolved real contact area. Ten participants performed sliding trials across three speeds and three normal forces with and without electrostatic actuation. Interfacial shear stress increased with speed and decreased with normal force; in both cases, these trends arose because real contact area varied more strongly than tangential force. Electrostatic actuation further reduced interfacial shear stress, as increasing voltage produced a larger increase in real contact area than in tangential force. These findings show that interfacial shear stress varies systematically with sliding conditions and electrostatic actuation, clarifying how changes in real contact area and interfacial shear stress combine to shape fingertip-surface friction.

Background and purpose: Patellofemoral pain syndrome (PFPS) is a multifaceted condition where proximal, local, and distal factors may contribute to symptoms and limitations. How these factors collectively contribute to PFPS remains poorly understood. Therefore, this study compared proximal, local, and distal mechanical characteristics between individuals with and without PFPS and investigated their association with pain intensity and functional disability. Methods: Eighty participants were included: 40 individuals with unilateral or bilateral PFPS, 40 healthy controls. Isometric muscle strength of hip, trunk, and ankle was assessed using a handheld dynamometer. Joint alignment (Q-angle, rearfoot angle, pelvic tilt) and muscle flexibility (iliotibial band, hamstrings, quadriceps, gastrocnemius, and soleus) were measured using standard clinical techniques. Pain severity was assessed using a visual analog scale (VAS), and functional disability was evaluated using the Kujala score. Results: Individuals with PFPS showed reduced iliotibial band flexibility, decreased hamstring and soleus length, lower hip abductor strength, and greater anterior and lateral pelvic tilt (all p < 0.02). Multivariate analysis identified reduced iliotibial band flexibility (OR = 7.48) and greater anterior pelvic tilt (OR = 11.75) as independent associates of PFPS. Anterior pelvic tilt predicted pain severity, while anterior trunk muscle strength and Q-angle predicted disability. Discussion: Reduced iliotibial band flexibility and increased anterior pelvic tilt were independently associated with PFPS, while anterior pelvic tilt predicted pain severity and anterior trunk muscle strength and Q-angle predicted functional disability. Clinical assessment and rehabilitation of PFPS should therefore extend beyond the knee to include iliotibial band flexibility, pelvic alignment, and trunk muscle strength.

[Purpose] By pairing repeated peripheral muscle fatigue induction with a functional and ADL-based assessment, this study tests whether hand muscle fatigue alone is sufficient to im pair fine motor performance in healthy adults performing ADL-inspired tasks. [Participants and Methods] Thirty healthy male and female university students performed 11 tasks twice, once in the pre-fatigue condition and once in the post-fatigue condition. The performance of each task was graded on a 0-4 scale. The score and the time to finish the task (TTFT) were recorded twice, for both the pre- and post-fatigue phases. Maximum force gen eration (MFG) of each participant's grip was recorded prior to the tasks in the pre-fatigue phase and again in the fatigue condition after performing the fatigue protocol. [Results] Muscle fatigue did not have a significant effect on the fine motor performance of the thirty participants, neither (TTFT) nor the scores of each task (p > 0.05) (r=0.08). In contrast, hand muscle fatigue led to a significant decrease in the mean (MFG) for both males and females (p<0.01). [Conclusion] Hand muscle fatigue led to a significant decrease in the mean grip MFG for both sexes. However, this reduction did not translate into impaired fine motor performance during ADL-like tasks. Consequently, under muscle fatigue, hand grip changes during fine tasks tested are rare and have minor to no impact on hand performance. This study suggests that acute peripheral muscle fatigue can coexist with preserved fine motor performance in healthy populations.

Conventional transfemoral amputation disrupts native neuromuscular pathways, limiting prosthetic joint control, sensory feedback, and the perception of the prosthesis as part of the body. To ameliorate these pathologies, we restored the agonist-antagonist relationship of residual muscles in two individuals with above-knee amputation through an interventional surgical revision. Participants trained with a bionic knee prosthesis before and after the surgical revision while generating neuromuscular, cortical, functional, and affective data. Both individuals demonstrated improvements after the revision that could not readily be attributed to training effects, including: 1) increased proprioceptive afferents and stronger activation in cortical regions associated with sensorimotor integration of their missing joints, 2) improved control of the bionic knee during functional tasks including sit-to-stand and stair ascent, and 3) generally greater prosthesis embodiment, proprioception, and phantom limb definition as assessed through questionnaires and interviews. In contrast, training outcomes were more participant-specific and more variably correlated with amount of exposure, especially before the revision. These pilot findings suggest that revisional augmentation of residual neuromuscular tissues to restore agonist-antagonist dynamics may promote sensorimotor coherence and enhance both functional and perceptual integration with a bionic prosthesis, and remaining participant-specific heterogeneities may be attributable to inter-individual difference in residual limbs neuromuscular system, amputation history, and personal beliefs about prosthesis usage.