simulera belastning av mjukdelar · 2019. 10. 23. · simulera belastning av mjukdelar . ligther...

SIMULERA BELASTNING AV MJUKDELAR

LIGTHer Seminarium Jönköping 3 Okt 2019

Sara Kallin CPO, Tekn. Lic, doktorandTekniska högskolan & HälsohögskolanJönköping University

MJUKDELSVÄVNADER - EXEMPEL

Sara Kallin

Wikimedia commons, Madhero88, https://commons.wikimedia.org/wiki/File:Skin_layers.png

Wikimedia Commons, National Institutes of Health, https://commons.wikimedia.org/wiki/File:Skeletal_muscle.png

https://commons.wikimedia.org/wiki/File:Skin_layers.png

https://commons.wikimedia.org/wiki/File:Skeletal_muscle.png

RAMVERK FÖRSTÅ UTVECKLINGTRYCKSÅR

Figure 3 p. 2232 in Coleman, S., Nixon, J., Keen, J., Wilson, L., McGinnis, E., Dealey, C., . . . Nelson, E. A. (2014). A new pressure ulcer conceptualframework. Journal of Advanced Nursing, 70(10), 2222-2234. Sara Kallin, 3 Okt 2019

DEEP TISSUE INJURY, DTI

• Töjning• Långsam, moderat töjning:

Kärl stängs => Metabolism ändras => Ansamling restprodukter =>pH sjunker => CELLDÖD

• Snabb, stor töjning:Deformation av celler => cell strukturen skadas, cellmembran, cytoskeleton => CELLDÖD

2-4 h

10 min

(Oomens, Bader, Loerakker, & Baaijens, 2015)

Synthesis of previous studiesTissue constructs and Animal studies

Sara Kallin, 3 Okt 2019

• Plantara mjukdelsvävnader hos diabetiker är mindre elastiska än hos icke-diabetiker (Ledoux, 2015, Pai & Ledoux, 2012)

• Huden mer elastisk hos yngre än hos äldre, friktionen hud-textilyta oberoende av kön och ålder (Gerhardt et al 2009)

VARIERANDE VÄVNADSEGENSKAPER


FINITA ELEMENT METODEN, FEM

FinitaElement Analys

Geometrier

Material egenskaper

Randvillkor


BÄCKEN, SITTSÅRLinder-Ganz, E., Yarnitzky, G., Yizhar, Z., Siev-Ner, I., & Gefen, A. (2009). Real-time finite element monitoring of sub-dermal tissuestresses in individuals with spinal cord injury: toward prevention of pressure ulcers. Annals of Biomedical Engineering, 37(2), 387-400.

EXEMPEL FINITA ELEMENT ANALYS (FEA) FÖR MJUKDELAR


FOT-ORTOSER för knäproblemLiu, X., & Zhang, M. (2013). Redistribution of knee stress using laterally wedged insole intervention: Finite element analysis of knee-ankle-foot complex. Clinical Biomechanics, 28(1), 61-67.

VÄVNADER i amputationsstumpPortnoy, S., Yizhar, Z., Shabshin, N., Itzchak, Y., Kristal, A., Dotan-Marom, Y., . . . Gefen, A. (2008). Internal mechanical conditions in the soft tissues of a residual limb of a trans-tibial amputee. JOURNAL OF BIOMECHANICS, 41(9), 1897-1909.

VÄVNADER i amputationsstump, Utvärdering påverkan av gångunderlagPortnoy, S., van Haare, J., Geers, R. P. J., Kristal, A., Siev-Ner, I., Seelen, H. A. M., . . . Gefen, A. (2010). Real-time subject-specific analyses of dynamic internal tissue loads in the residual limb of transtibial amputees. Medical Engineering & Physics, 32(4), 312-323.

VÄVNADER i amputationsstump, Utvärdering protesfötterPortnoy, S., Kristal, A., Gefen, A., & Siev-Ner, I. (2012). Outdoor dynamic subject-specific evaluation of internal stresses in the residual limb: Hydraulic energy-stored prosthetic foot compared to conventional energy-stored prosthetic feet. Gait & Posture, 35(1), 121-125.

VÄVNADER i amputationsstump, Utvärdering olika linerCagle, J. C., Reinhall, P. G., Allyn, K. J., McLean, J., Hinrichs, P., Hafner, B. J., & Sanders, J. E. (2018). A finite element model to assess transtibial prosthetic sockets with elastomeric liners. Medical & Biological Engineering & Computing, 56(7), 1227-1240.

FEA Mänskliga mjukdelar


Geometrier

Material egenskaper

Randvillkor

Förenklade material-modellerBegränsad data

Sammanslagna lagerFörenklade former

StatikFörenklade laster


FEA Mänskliga mjukdelar


Geometrier

Material egenskaper

Randvillkor

Förenklade material-modellerBegränsad data

Sammanslagna lagerFörenklade former

StatikFörenklade laster

Hur tillförlitliga resultat?

Förenklat förmycket?


MULTIDISCIPLINÄRT FORSKNINGSPROJEKT


Långsiktigt mål: Förebygga trycksår och djupa vävnadsskador genom attoptimera kroppsnära produkter

EN BÖRJAN…• Undersöka mekaniska konsekvenser av olika

vävnadsrepresentation i en simuleringsmodell av underben (Study I)

• Aim: To investigate the mechanical effects of two sets of representations for lower leg soft tissues exposed to external load


Modell underben

Kallin, S., Rashid, A., Salomonsson, K., Hansbo, P., in manuscript


Studie I

5 vs 6 material:

Fascia ochMuskel

Kombineradevs Separata

FEA:Abaqus 6.14-3/Standard Plane strainElement: CPE8H, CPE6H, 26 330stKallin, S. ©

Kallin, S. ©

Last: Proteshylse-geometrier

Kallin et al, in manuscript, Kallin (2019)

• Total Contact Concept (TC)• Total surface bearing (TSB)• Hydrostatic socket (HS)

(Fergason & Smith, 1999)

Hylsor 4.5 mm, material PETG


Studie I

Kallin, S. ©


MaterialOgden Strain Energy function:

𝑈𝑈 = ∑𝑖𝑖=1𝑁𝑁 𝜇𝜇𝑖𝑖𝛼𝛼𝑖𝑖

(𝜆𝜆1𝛼𝛼𝑖𝑖 + 𝜆𝜆2

𝛼𝛼𝑖𝑖 + 𝜆𝜆3𝛼𝛼𝑖𝑖 − 3) + ∑𝑖𝑖=1𝑁𝑁 1

𝐷𝐷𝑖𝑖𝐽𝐽𝑒𝑒𝑒𝑒 − 1 2𝑖𝑖

Yeoh polynomial:

𝑈𝑈 = �𝑖𝑖=1

3𝐶𝐶𝑖𝑖0(𝐼𝐼1 − 3)𝑖𝑖

Studie I

Kallin, S. ©


MaterialOgden Strain Energy function:

𝑈𝑈 = ∑𝑖𝑖=1𝑁𝑁 𝜇𝜇𝑖𝑖𝛼𝛼𝑖𝑖

(𝜆𝜆1𝛼𝛼𝑖𝑖 + 𝜆𝜆2

𝛼𝛼𝑖𝑖 + 𝜆𝜆3𝛼𝛼𝑖𝑖 − 3) + ∑𝑖𝑖=1𝑁𝑁 1

𝐷𝐷𝑖𝑖𝐽𝐽𝑒𝑒𝑒𝑒 − 1 2𝑖𝑖

Yeoh polynomial:

𝑈𝑈 = �𝑖𝑖=1

3𝐶𝐶𝑖𝑖0(𝐼𝐼1 − 3)𝑖𝑖

Studie I

Kallin, S. Deformation of human tissues –experimental and numerical aspects, 2019 p.41

Kallin, S. ©

Separate

Combined

TC TSB HS

Effektiv spänningRESULTAT


Studie I

Kallin, S. ©

Kallin et al, (in manuscript), Kallin (2019)

Separate

Combined

TC TSB HS

Skjuv-töjning


Studie IRESULTAT

Kallin, S. ©



RESULTATKontakt-tryck

Kallin, S. ©


NIVÅER


Studie I

Combined max: 2,27 kPa

Skjuvspänning muskler (HS)

Kallin, S. ©

Kallin, S. ©


Studie I

Combined max: 2,27 kPa

Detailed max: 2,95 kPa

Skjuvspänning muskler (HS)NIVÅER

Kallin, S. ©

Kallin, S. ©

NIVÅER


Studie ICombined max: 2,27 kPa

Detailed max: 2,95 kPa

Detailed samma plats: 0,010 kPa

Combined samma plats: 0,340 kPa

Skjuvspänning muskler (HS)

Kallin, S. ©

Kallin, S. ©


⇒ Separata vävnadslager och material i modeller VIKTIGT

⇒ Tolka FEA med försiktighet

UTVECKLA UNDERLAGEN FÖR FEA• Identifiera vävnadslager och typer• Bestämma individspecifika materialegenskaper med

relevanta experiment och materialmodeller• Realistiska lastfall

• Validera simuleringsmodeller• Simulera individspecifika

situationer

A B


Kallin, S. ©

INTEGRERA I PROCESSER

• MR/CT för geometri• Modellering och simulering• Tillverkning• Utvärdering

Exempel:

Colombo, G., Rizzi, C., Regazzoni, D., & Vitali, A. (2018). 3D interactive environment for the design of medical devices. International Journal of Interactive Design and Manufacturing - Ijidem, 12(2), 699-715. doi:10.1007/s12008-018-0458-8


REFERENSERCagle, J. C., Reinhall, P. G., Allyn, K. J., McLean, J., Hinrichs, P., Hafner, B. J., & Sanders, J. E. (2018). A finite element model to assess transtibial prosthetic sockets with elastomeric liners. Medical & Biological Engineering & Computing, 56(7), 1227-1240.

Coleman, S., Nixon, J., Keen, J., Wilson, L., McGinnis, E., Dealey, C., . . . Nelson, E. A. (2014). A new pressure ulcer conceptual framework. Journal of Advanced Nursing, 70(10), 2222-2234.

Colombo, G., Rizzi, C., Regazzoni, D., & Vitali, A. (2018). 3D interactive environment for the design of medical devices. International Journal of Interactive Design and Manufacturing - Ijidem, 12(2), 699-715. doi:10.1007/s12008-018-0458-8

Gerhardt, L. C., Lenz, A., Spencer, N. D., Münzer, T., & Derler, S. (2009). Skin-textile friction and skin elasticity in young and aged persons. Skin Research And Technology: Official Journal Of International Society For Bioengineering And The Skin (ISBS) [And] International Society For Digital Imaging Of Skin (ISDIS) [And] International Society For Skin Imaging (ISSI), 15(3), 288-298. doi:10.1111/j.1600-0846.2009.00363.x

Kallin, S., Rashid, A., Salomonsson, K., & Hansbo, P. (2019, 2019 July 31). Comparison of mechanical conditions in a lower leg model with 5 or 6 tissue types while exposed to prosthetic sockets applying finite element analysis [Preprint]. Manuscript Research paper. (1907.13340). arXiv.org, arXiv.org: 1907.13340.

Kallin, S. (2019). Deformation of human soft tissues : Experimental and numerical aspects. (049 Licentiate thesis, monograph), Jönköping University, School of Engineering, Jönköping. Retrieved from http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-45653 DiVA database.

Ledoux, W. R. (2015). The Biomechanics of Aging and Diabetic Plantar Soft Tissue. In B. Derby & R. Akhtar (Eds.), Mechanical Properties of Aging Soft Tissues (pp. 187-206). Cham: Springer International Publishing.

Linder-Ganz, E., Yarnitzky, G., Yizhar, Z., Siev-Ner, I., & Gefen, A. (2009). Real-time finite element monitoring of sub-dermal tissue stresses in individuals with spinal cord injury: toward prevention of pressure ulcers. Annals of Biomedical Engineering, 37(2), 387-400.

Liu, X., & Zhang, M. (2013). Redistribution of knee stress using laterally wedged insole intervention: Finite element analysis of knee-ankle-foot complex. Clinical Biomechanics, 28(1), 61-67.

Oomens, C. W. J., Bader, D. L., Loerakker, S., & Baaijens, F. (2015). Pressure induced deep tissue injury explained. Annals of Biomedical Engineering, 43(2), 297-305. doi:10.1007/s10439-014-1202-6

Pai, S., & Ledoux, W. R. (2012). The shear mechanical properties of diabetic and non-diabetic plantar soft tissue. JOURNAL OF BIOMECHANICS, 45(2), 364-370. doi:10.1016/j.jbiomech.2011.10.021

Portnoy, S., Kristal, A., Gefen, A., & Siev-Ner, I. (2012). Outdoor dynamic subject-specific evaluation of internal stresses in the residual limb: Hydraulic energy-stored prosthetic foot compared to conventional energy-stored prosthetic feet. Gait & Posture, 35(1), 121-125.

Portnoy, S., van Haare, J., Geers, R. P. J., Kristal, A., Siev-Ner, I., Seelen, H. A. M., . . . Gefen, A. (2010). Real-time subject-specific analyses of dynamic internal tissue loads in the residual limb of transtibial amputees. Medical Engineering & Physics, 32(4), 312-323.

Portnoy, S., Yizhar, Z., Shabshin, N., Itzchak, Y., Kristal, A., Dotan-Marom, Y., . . . Gefen, A. (2008). Internal mechanical conditions in the soft tissues of a residual limb of a trans-tibial amputee. JOURNAL OF BIOMECHANICS, 41(9), 1897-1909.


TACK!Sara [email protected] 12 74Hälsohögskolan & Tekniska högskolanJönköping University

Tekn. Licentiat avhandling: Deformation of human soft tissues – Experimental and numerical aspects, 2019 http://hj.diva-portal.org/smash/record.jsf?pid=diva2:1344790 , http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-45653


mailto:[email protected]

http://hj.diva-portal.org/smash/record.jsf?pid=diva2:1344790

http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-45653

simulera belastning av mjukdelar · 2019. 10. 23. · simulera belastning av mjukdelar . ligther...

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