METHODS: This review article discusses the experimental and computational methods in the study of HUA. The discussion includes computational fluid dynamics approach and steps involved in the modeling used to investigate the flow characteristics of HUA. From inception to May 2020, databases of PubMed, Embase, Scopus, the Cochrane Library, BioMed Central, and Web of Science have been utilized to conduct a thorough investigation of the literature. There had been no language restrictions in publication and study design of the database searches. A total of 117 articles relevant to the topic under investigation were thoroughly and critically reviewed to give a clear information about the subject. The article summarizes the review in the form of method of studying the HUA, CFD approach in HUA, and the application of CFD for predicting HUA obstacle, including the type of CFD commercial software are used in this research area.
RESULTS: This review found that the human upper airway was well studied through the application of computational fluid dynamics, which had considerably enhanced the understanding of flow in HUA. In addition, it assisted in making strategic and reasonable decision regarding the adoption of treatment methods in clinical settings. The literature suggests that most studies were related to HUA simulation that considerably focused on the aspects of fluid dynamics. However, there is a literature gap in obtaining information on the effects of fluid-structure interaction (FSI). The application of FSI in HUA is still limited in the literature; as such, this could be a potential area for future researchers. Furthermore, majority of researchers present the findings of their work through the mechanism of airflow, such as that of velocity, pressure, and shear stress. This includes the use of Navier-Stokes equation via CFD to help visualize the actual mechanism of the airflow. The above-mentioned technique expresses the turbulent kinetic energy (TKE) in its result to demonstrate the real mechanism of the airflow. Apart from that, key result such as wall shear stress (WSS) can be revealed via turbulent kinetic energy (TKE) and turbulent energy dissipation (TED), where it can be suggestive of wall injury and collapsibility tissue to the HUA.
METHODS: Male participants (age 22.0±3.4) performed ramped isometric knee extensions at knee joint angles of 90°, 70°, 50° and 30° of flexion. Strain patterns of the anterior and posterior regions of the patellar tendon were determined using real-time B-mode ultrasonography at each knee joint angle. Regional strain measures were compared using an automated pixel tracking method.
RESULTS: Strain was seen to be greatest for both the anterior and posterior regions with the knee at 90° (7.76±0.89% and 5.06±0.76%). Anterior strain was seen to be significantly greater (p<0.05) than posterior strain for all knee angles apart from 30°, 90°=(7.76vs. 5.06%), 70°=(4.77vs. 3.75%), and 50°=(3.74vs. 2.90%). The relative strain (ratio of anterior to posterior), was greatest with the knee joint angle at 90°, and decreased as the knee joint angle reduced.
CONCLUSIONS: The results from this study indicate that not only are there greater absolute tendon strains with the knee in greater flexion, but that the knee joint angle affects the regional strain differentially, resulting in greater shear between the tendon layers with force application when the knee is in greater degrees of flexion. These results have important implications for rehabilitation and training.