Investigating ACL length, strain and tensile force in high impact and daily activities through machine learning.

Anterior cruciate ligament (ACL) reconstruction rates are rising, particularly among female athletes, though causes remain unclear. This study: (i) identify accurate machine learning models to predict ACL length, strain, and force during six high-impact and daily activities; (ii) assess the significance of kinematic and constitutional parameters; and (iii) analyse gender-based injury risk patterns. Using 9,375 observations per variable, 42 models were trained.

Gaussian random fields as an abstract representation of patient metadata for multimodal medical image segmentation.

Growing rates of chronic wound occurrence, especially in patients with diabetes, has become a recent concerning trend. Chronic wounds are difficult and costly to treat, and have become a serious burden on health care systems worldwide. Innovative deep learning methods for the detection and monitoring of such wounds have the potential to reduce the impact to patients and clinicians.

An enhanced harmonic densely connected hybrid transformer network architecture for chronic wound segmentation utilising multi-colour space tensor merging.

Chronic wounds and associated complications present ever growing burdens for clinics and hospitals world wide. Venous, arterial, diabetic, and pressure wounds are becoming increasingly common globally. These conditions can result in highly debilitating repercussions for those affected, with limb amputations and increased mortality risk resulting from infection becoming more common.

Development of a Body-Worn Textile-Based Strain Sensor: Application to Diabetic Foot Assessment.

Diabetic Foot Ulcers (DFUs) are a significant health and economic burden, potentially leading to limb amputation, with a severe impact on a person's quality of life. During active movements like gait, the monitoring of shear has been suggested as an important factor for effective prevention of DFUs. It is proposed that, in textiles, strain can be measured as a proxy for shear stress at the skin.

An active insole to reduce plantar pressure loading: using predictive finite element driven soft hydraulic actuators to minimise plantar pressure and the pressure time integral for diabetic foot ulceration risk management.

Objective: This paper aims to design, manufacture and evaluate an active insole to reduce plantar tissue loading to minimise the risk of diabetic foot ulceration for people living with diabetes.

Methods: A prototype hydraulic soft robotic actuating insole was produced. It was controlled by an approximate finite element model of the participants' foot with a cost function to minimise plantar pressure loading and the pressure time integral.

Developing a Smart Sensing Sock to Prevent Diabetic Foot Ulcers: Qualitative Focus Group and Interview Study.

Background: Diabetic foot ulcers are common and costly. Most cases are preventable, although few interventions exist to reliably support patients in performing self-care. Emerging technologies are showing promise in this domain, although patient and health care provider perspectives are rarely incorporated into digital intervention designs.

A Faster Walking Speed Is Important for Improving Biomechanical Function and Walking Performance in Stroke Survivors.

This study compares joint kinematics and kinetics of young stroke survivors who walk <0.79 m/s (slow) or >0.80 m/s (fast) with reference to a healthy able-bodied group and provides clinical recommendations for guiding the gait rehabilitation of stroke survivors.

Machine learning to predict morphology, topography and mechanical properties of sustainable gelatin-based electrospun scaffolds.

Electrospinning is an outstanding manufacturing technique for producing nano-micro-scaled fibrous scaffolds comparable to biological tissues. However, the solvents used are normally hazardous for the health and the environment, which compromises the sustainability of the process and the industrial scaling. This novel study compares different machine learning models to predict how green solvents affect the morphology, topography and mechanical properties of gelatin-based scaffolds.

Handheld dynamometry: Validity and reliability of measuring hip joint rate of torque development and peak torque.

Introduction: Measuring rate of torque development (RTD) and peak torque (PT) for hip muscle performance presents challenges in clinical practice. This study investigated the construct validity of a handheld dynamometer (HHD) versus an isokinetic dynamometer (IKD), and intra-rater repeated reliability for RTD and PT and their relationship in hip joint movements.

Methods: Thirty healthy individuals (mean age = 30 ± 8 years, 13 males) underwent two test sessions in a single day.

High Velocity Passive Stretching Mimics Eccentric Exercise in Cerebral Palsy and May Be Used to Increase Spastic Muscle Fascicle Length.

Muscle fascicles are shorter and stiffer than normal in spastic Cerebral Palsy (CP). Increasing fascicle length (FL) has been attempted in CP, the outcomes of which have been unsatisfactory. In healthy muscles, FL can be increased using eccentric exercise at high velocities (ECC).

Machine learning to mechanically assess 2D and 3D biomimetic electrospun scaffolds for tissue engineering applications: Between the predictability and the interpretability.

Currently, the use of autografts is the gold standard for the replacement of many damaged biological tissues. However, this practice presents disadvantages that can be mitigated through tissue-engineered implants. The aim of this study is to explore how machine learning can mechanically evaluate 2D and 3D polyvinyl alcohol (PVA) electrospun scaffolds (one twisted filament, 3 twisted filament and 3 twisted/braided filament scaffolds) for their use in different tissue engineering applications.

The effect of calcaneus and metatarsal head offloading insoles on healthy subjects' gait kinematics, kinetics, asymmetry, and the implications for plantar pressure management: A pilot study.

Background: The global number of people with diabetes is estimated to reach 643 million by 2030 of whom 19-34% will present with diabetic foot ulceration. Insoles which offload high-risk ulcerative regions on the foot, by removing insole material, are the main contemporary conservative treatment to maintain mobility and reduce the likelihood of ulceration. However, their effect on the rest of the foot and relationship with key gait propulsive and balance kinematics and kinetics has not been well researched.

Diabetic foot ulcers segmentation challenge report: Benchmark and analysis.

Monitoring the healing progress of diabetic foot ulcers is a challenging process. Accurate segmentation of foot ulcers can help podiatrists to quantitatively measure the size of wound regions to assist prediction of healing status. The main challenge in this field is the lack of publicly available manual delineation, which can be time consuming and laborious.

Acute Effects of Vibrating Insoles on Dynamic Balance and Gait Quality in Individuals With Diabetic Peripheral Neuropathy: A Randomized Crossover Study.

Objective: This study investigated the effects of vibrating insoles on dynamic balance and gait quality during level and stair walking and explored the influence of vibration type and frequency in individuals with diabetic peripheral neuropathy (DPN).

Research Design And Methods: Twenty-two men with DPN were assessed for gait quality and postural and dynamic balance during walking and stair negotiation using a motion capture system and force plates across seven vibratory insole conditions (Vcs) versus a control (Ctrl) condition (insole without vibration). Vibration was applied during standing and walking tasks, and 15-min rest-stop periods without vibration were interposed between conditions.

Offloading and adherence through technological advancements: Modern approaches for better foot care in diabetes.

Objective: This manuscript aims to provide a review and synthesis of contemporary advancements in footwear, sensor technology for remote monitoring, and digital health, with a focus on improving offloading and measuring and enhancing adherence to offloading in diabetic foot care.

Methods: A narrative literature review was conducted by sourcing peer-reviewed articles, clinical studies, and technological innovations. This paper includes a review of various strategies, from specifically designed footwear, smart insoles and boots to using digital health interventions, which aim to offload plantar pressure and help prevent and manage wounds more effectively by improving the adherence to such offloading.

Psychosocial Care for People With Diabetic Neuropathy: Time for Action.

Psychological factors and psychosocial care for individuals with diabetic neuropathy (DN), a common and burdensome complication of diabetes, are important but overlooked areas. In this article we focus on common clinical manifestations of DN, unremitting neuropathic pain, postural instability, and foot complications, and their psychosocial impact, including depression, anxiety, poor sleep quality, and specific problems such as fear of falling and fear of amputation. We also summarize the evidence regarding the negative impact of psychological factors such as depression on DN, self-care tasks, and future health outcomes.

Artificial intelligence for automated detection of diabetic foot ulcers: A real-world proof-of-concept clinical evaluation.

Objective: Conduct a multicenter proof-of-concept clinical evaluation to assess the accuracy of an artificial intelligence system on a smartphone for automated detection of diabetic foot ulcers.

Methods: The evaluation was undertaken with patients with diabetes (n = 81) from September 2020 to January 2021. A total of 203 foot photographs were collected using a smartphone, analysed using the artificial intelligence system, and compared against expert clinician judgement, with 162 images showing at least one ulcer, and 41 showing no ulcer.

Diabetes foot complications and standardized mortality rate in type 2 diabetes.

Aim: To quantify the impact of foot complications on mortality outcomes in people with type 2 diabetes (T2D), and how routinely measured factors might modulate that risk.

Materials And Methods: Data for individuals with T2D for 2010-2020, from the Salford Integrated Care Record (Salford, UK), were extracted for laboratory and clinical data, and deaths. Annual expected deaths were taken from Office of National Statistics mortality data.

Can we achieve biomimetic electrospun scaffolds with gelatin alone?

Gelatin is a natural polymer commonly used in biomedical applications in combination with other materials due to its high biocompatibility, biodegradability, and similarity to collagen, principal protein of the extracellular matrix (ECM). The aim of this study was to evaluate the suitability of gelatin as the sole material to manufacture tissue engineering scaffolds by electrospinning. Gelatin was electrospun in nine different concentrations onto a rotating collector and the resulting scaffold's mechanical properties, morphology and topography were assessed using mechanical testing, scanning electron microscopy and white light interferometry, respectively.

Associations between long-term exercise participation and lower limb joint and whole-bone geometry in young and older adults.

Features of lower limb bone geometry are associated with movement kinematics and clinical outcomes including fractures and osteoarthritis. Therefore, it is important to identify their determinants. Lower limb geometry changes dramatically during development, partly due to adaptation to the forces experienced during physical activity.

A Signal Processing Method for Assessing Ankle Torque with a Custom-Made Electronic Dynamometer in Participants Affected by Diabetic Peripheral Neuropathy.

Portable, custom-made electronic dynamometry for the foot and ankle is a promising assessment method that enables foot and ankle muscle function to be established in healthy participants and those affected by chronic conditions. Diabetic peripheral neuropathy (DPN) can alter foot and ankle muscle function. This study assessed ankle toque in participants with diabetic peripheral neuropathy and healthy participants, with the aim of developing an algorithm for optimizing the precision of data processing and interpretation of the results and to define a reference frame for ankle torque measurement in both healthy participants and those affected by DPN.

Acute Effects of Sedentary Behavior on Ankle Torque Assessed with a Custom-Made Electronic Dynamometer.

Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared the acute effects of one day of prolonged sitting and one day of low-to-moderate level of activity on ankle torque in one group of eight healthy participants.

A Custom-Made Electronic Dynamometer for Evaluation of Peak Ankle Torque after COVID-19.

The negative effects of SARS-CoV-2 infection on the musculoskeletal system include symptoms of fatigue and sarcopenia. The aim of this study is to assess the impact of COVID-19 on foot muscle strength and evaluate the reproducibility of peak ankle torque measurements in time by using a custom-made electronic dynamometer. In this observational cohort study, we compare two groups of four participants, one exposed to COVID-19 throughout measurements and one unexposed.

Site-Specific, Critical Threshold Barefoot Peak Plantar Pressure Associated with Diabetic Foot Ulcer History: A Novel Approach to Determine DFU Risk in the Clinical Setting.

Barefoot peak plantar pressures (PPPs) are elevated in diabetes patients with neuropathic foot ulcer (DFU) history; however, there is limited reported evidence for a causative link between high barefoot PPP and DFU risk. We aimed to determine, using a simple mat-based methodology, the site-specific, barefoot PPP critical threshold that will identify a plantar site with a previous DFU. In a cross-sectional study, barefoot, site-specific PPPs were measured with normal gait for patients with DFU history ( = 21) and healthy controls ( = 12), using a validated carbon footprint system.