MyMedR

Displaying publications 41 - 46 of 46 in total

Abstract:

Sort:

Stress Distributions and Micromovement of Fragment Bone of Pilon Fracture Treated With External Fixator: A Finite Element Analysis

Ramlee MH, Gan HS, Daud SA, Abdul Wahab A, Abdul Kadir MR

J Foot Ankle Surg, 2020 7 1;59(4):664-672.
PMID: 32600559 DOI: 10.1053/j.jfas.2019.09.006

Osteoporosis and osteoarthritis are common pathological problems of the human bone tissue. There are some cases of pilon fractures associated with these 2 pathological conditions. In terms of treatment, for a normal and healthy bone with pilon fracture, the use of the Delta external fixator is a favorable option because it can allow early mobilization for patients and provide stability for the healing process. However, the stability of the external fixator differs when there is low bone stiffness, which has not been previously investigated. Therefore, this study was conducted to determine the stability of the external fixator to treat pilon fracture associated with osteoporosis and osteoarthritis, particularly to differentiate the stress distribution and micromovement of fracture fragment. Three-dimensional finite element models of the ankle and foot bones were reconstructed based on the computed tomography datasets. The bones consisted of 5 metatarsal, 3 cuneiform, and 1 each of cuboid, navicular, calcaneus, talus, fibula, and tibia bones. They were assigned with linear isotropic behavior. The ankle joint consisted of ligament and cartilage, and they were assigned with the use of linear links and the Mooney-Rivlin model, respectively. During simulation of the gait cycle, 70 N and 350 N were applied axially to the tibia bone to represent the swing and stance phases, respectively. The metatarsal and calcaneus bones were fixed to prevent any movement of the rigid body. The study found that the greatest von Mises stress value was observed at the pin-bone interface for the osteoporosis (108 MPa) model, followed by the osteoarthritis (87 MPa) and normal (44 MPa) models, during the stance phase. For micromovement, the osteoporosis model had the largest value at 0.26 mm, followed by the osteoarthritis (0.09 mm) and normal (0.03 mm) models. In conclusion, the greatest magnitudes of stress and micromovement were observed for the osteoporosis bone and extra care should be taken to treat pilon fracture associated with this pathological condition.
New Device for Intrinsic Hand Muscle Strength Measurement: An Alternative to Strain Gauge Handheld Dynamometer

Madhanagopal J, Singh OP, Mohan V, Sathasivam KV, Omar AH, Abdul Kadir MR

Eval Health Prof, 2019 03;42(1):103-113.
PMID: 28868907 DOI: 10.1177/0163278717727568

An accurate measurement of intrinsic hand muscle strength (IHMS) is required by clinicians for effective clinical decision-making, diagnosis of certain diseases, and evaluation of the outcome of treatment. In practice, the clinicians use Intrins-o-meter and Rotterdam Intrinsic Hand Myometer for IHMS measurement. These are quite bulky, expensive, and possess poor interobserver reliability (37-52%) and sensitivity. The purpose of this study was to develop an alternative lightweight, accurate, cost-effective force measurement device with a simple electronic circuit and test its suitability for IHMS measurement. The device was constructed with ketjenblack/deproteinized natural rubber sensor, 1-MΩ potential divider, and Arduino Uno through the custom-written software. Then, the device was calibrated and tested for accuracy and repeatability within the force range of finger muscles (100 N). The 95% limit of agreement in accuracy from -1.95 N to 2.06 N for 10 to 100 N applied load and repeatability coefficient of ±1.91 N or 6.2% was achieved. Furthermore, the expenditure for the device construction was around US$ 53. For a practical demonstration, the device was tested among 16 participants for isometric strength measurement of the ulnar abductor and dorsal interossei. The results revealed that the performance of the device was suitable for IHMS measurement.
Assessment of compressive failure process of cortical bone materials using damage-based model

Ng TP, R Koloor SS, Djuansjah JRP, Abdul Kadir MR

J Mech Behav Biomed Mater, 2017 02;66:1-11.
PMID: 27825047 DOI: 10.1016/j.jmbbm.2016.10.014

The main failure factors of cortical bone are aging or osteoporosis, accident and high energy trauma or physiological activities. However, the mechanism of damage evolution coupled with yield criterion is considered as one of the unclear subjects in failure analysis of cortical bone materials. Therefore, this study attempts to assess the structural response and progressive failure process of cortical bone using a brittle damaged plasticity model. For this reason, several compressive tests are performed on cortical bone specimens made of bovine femur, in order to obtain the structural response and mechanical properties of the material. Complementary finite element (FE) model of the sample and test is prepared to simulate the elastic-to-damage behavior of the cortical bone using the brittle damaged plasticity model. The FE model is validated in a comparative method using the predicted and measured structural response as load-compressive displacement through simulation and experiment. FE results indicated that the compressive damage initiated and propagated at central region where maximum equivalent plastic strain is computed, which coincided with the degradation of structural compressive stiffness followed by a vast amount of strain energy dissipation. The parameter of compressive damage rate, which is a function dependent on damage parameter and the plastic strain is examined for different rates. Results show that considering a similar rate to the initial slope of the damage parameter in the experiment would give a better sense for prediction of compressive failure.
Finite element analysis of the wrist in stroke patients: the effects of hand grip

Ramlee MH, Beng GK, Bajuri N, Abdul Kadir MR

Med Biol Eng Comput, 2018 Jul;56(7):1161-1171.
PMID: 29209961 DOI: 10.1007/s11517-017-1762-3

The provision of the most suitable rehabilitation treatment for stroke patient remains an ongoing challenge for clinicians. Fully understanding the pathomechanics of the upper limb will allow doctors to assist patients with physiotherapy treatment that will aid in full arm recovery. A biomechanical study was therefore conducted using the finite element (FE) method. A three-dimensional (3D) model of the human wrist was reconstructed using computed tomography (CT)-scanned images. A stroke model was constructed based on pathological problems, i.e. bone density reductions, cartilage wane, and spasticity. The cartilages were reconstructed as per the articulation shapes in the joint, while the ligaments were modelled using linear links. The hand grip condition was mimicked, and the resulting biomechanical characteristics of the stroke and healthy models were compared. Due to the lower thickness of the cartilages, the stroke model reported a higher contact pressure (305 MPa), specifically at the MC1-trapezium. Contrarily, a healthy model reported a contact pressure of 228 MPa. In the context of wrist extension and displacement, the stroke model (0.68° and 5.54 mm, respectively) reported a lower magnitude than the healthy model (0.98° and 9.43 mm, respectively), which agrees with previously reported works. It was therefore concluded that clinicians should take extra care in rehabilitation treatment of wrist movement in order to prevent the occurrence of other complications. Graphical abstract ᅟ.
Effects of Blood Flow Restriction Training on Muscle Strength and Pain in Patients With Knee Injuries: A Meta-Analysis

Li S, Shaharudin S, Abdul Kadir MR

Am J Phys Med Rehabil, 2021 Apr 01;100(4):337-344.
PMID: 33727516 DOI: 10.1097/PHM.0000000000001567

BACKGROUND: Due to the pain caused by knee injuries, low-load resistance training with blood flow restriction (L-BFR) may be a potential adjuvant therapeutic tool in the rehabilitation of knee injuries. This review aimed to analyze the effectiveness of L-BFR training modality in knee rehabilitation.
DESIGN: A meta-analysis was conducted to determine the potential impact of blood flow restriction on patients with knee injuries. PubMed, EBSCO, and Web of Science databases were searched for eligible studies from January 2000 until January 2020. The mean differences of the data were analyzed using Revman 5.3 software with a 95% confidence interval.
RESULTS: Nine studies fulfilled the inclusion criteria. These studies involved 179 patients who received L-BFR, 96 patients who underwent high-load resistance training, and another 94 patients who underwent low-load resistance training. The analysis of pooled data showed that patients in both the L-BFR (standardized mean difference, 0.83 [0.53, 1.14], P < 0.01) and high-load resistance training (standardized mean difference, -0.09 [-0.43, 0.24], P = 0.58) groups experienced an increase in muscle strength after the training. In addition, pain score was significantly reduced in the L-BFR group compared with the other two groups (standardized mean difference, -0.61 [-1.19, -0.03], P = 0.04).
CONCLUSIONS: Muscle strength increased after L-BFR and high-load resistance training compared with low-load resistance training. Furthermore, pain score was significantly reduced after L-BFR. Hence, L-BFR is a potential intervention to be applied in rehabilitation of knee injuries.
Fulltext Investigation on three-dimensional printed prosthetics leg sockets coated with different reinforcement materials: analysis on mechanical strength and microstructural

Ramlee MH, Ammarullah MI, Mohd Sukri NS, Faidzul Hassan NS, Baharuddin MH, Abdul Kadir MR

Sci Rep, 2024 Mar 21;14(1):6842.
PMID: 38514731 DOI: 10.1038/s41598-024-57454-8

Previous research has primarily focused on pre-processing parameters such as design, material selection, and printing techniques to improve the strength of 3D-printed prosthetic leg sockets. However, these methods fail to address the major challenges that arise post-printing, namely failures at the distal end of the socket and susceptibility to shear failure. Addressing this gap, the study aims to enhance the mechanical properties of 3D-printed prosthetic leg sockets through post-processing techniques. Fifteen PLA + prosthetic leg sockets are fabricated and reinforced with four materials: carbon fiber, carbon-Kevlar fiber, fiberglass, and cement. Mechanical and microstructural properties of the sockets are evaluated through axial compression testing and scanning electron microscopy (SEM). Results highlight superior attributes of cement-reinforced sockets, exhibiting significantly higher yield strength (up to 89.57% more than counterparts) and higher Young's modulus (up to 76.15% greater). SEM reveals correlations between microstructural properties and socket strength. These findings deepen the comprehension of 3D-printed prosthetic leg socket post-processing, presenting optimization prospects. Future research can focus on refining fabrication techniques, exploring alternative reinforcement materials, and investigating the long-term durability and functionality of post-processed 3D-printed prosthetic leg sockets.