Functional Biomechanics

Das Projekt InnoTreat: Towards Personalized Treatment Decisions with Digital Twins zielt darauf ab, die klinische Diagnose und Behandlungsentscheidungen bei Schulterpathologien zu präzisieren. Durch die Integration von patientenspezifischer Anatomie in biomechanische Simulationen soll das Projekt Einblick in die zugrunde liegenden Mechanismen der Schulterpathologie geben und dadurch Rehabilitationsprogramme zielgerichteter abstimmen. Das Projekt konzentriert sich auf Rupturen der Rotatorenmanschette, von denen ein erheblicher Teil der Bevölkerung betroffen ist, und befasst sich mit den Grenzen der derzeitigen Behandlungsmöglichkeiten durch die Entwicklung einer digitalen Zwillingsanwendung, die patientenspezifische Diagnosen und veränderte Biomechanik visualisiert. Die institutionenübergreifende Zusammenarbeit nutzt die Expertise in der Bildgebung (Universität Zürich), der Biomechanik (ZHAW) und der klinischen Praxis (Universitätsspital Basel) im Rahmen einer iterativen Forschungszusammenarbeit.

In Switzerland, 1.5 million people suffer from low back pain (LBP), which is often the cause of disability [1]. Non-specific LBP is a major cause of high healthcare costs in developed countries and often leads to early retirement [2]. The development of musculoskeletal assessment through remote app-assisted therapeutic home training may be useful for individuals with non-specific LBP, providing initial support for its implementation in primary care in the patient's home [3]. App-supported therapeutic solutions allow healthcare professionals to prescribe and monitor rehabilitation programs remotely. These innovative solutions have the potential to reduce healthcare costs and provide clinical outcomes comparable or even better than conventional physiotherapy (PT), especially for patients in remote areas [4]. Akina Cloud, a digital health application developed by an ETH spin-off to support therapeutic exercises in people with musculoskeletal disorders, is the first remote app-assisted therapeutic home training solution available in Switzerland. It provides patients with exercise and educational content and facilitates communication between patients and therapists via the application. The aim of this study is to show the efficacy of the remote app-assisted physiotherapy through Akina Cloud in patients with non-specific LBP. 

In December 2021, the new research unit ‘Clinical Biomechanics and Ergonomics Engineering’ (CADENCE) was formed at Department of Biomedical Engineering (DBE) at the University of Basel (https://dbe.unibas.ch/en/research/biomechanics-and-biomaterials/cadence/) comprising the research groups ‘Functional Biomechanics’, ‘Robot-assisted Theragnostics’, ‘Paediatric Orthopaedic Biomechanics and Musculoskeletal Modelling’, and ‘Spine Biomechanics’. CADENCE facilitates innovative and groundbreaking interdisciplinary research in biomedical engineering and biomechanics and serves as teaching facility for courses on diagnostic and therapeutic technologies within the new Master of Science program and the PhD programs at the DBE. The R`Equip grant supports CADENCE in the purchase of a range of state-of-the-art sensor technologies and the world’s first 3D gait rehabilitation robot ‘The FLOAT’. This investment is critical for the unique and internationally leading role of the research groups in the research and innovation ecosystem in the Basel region.

RoLSSroice - Role of spinal load in the pathophysiology of lumbar spinal stenosis: a translational approach combining clinical, functional and radiological parameters, in vivo biomechanical experiments and advanced in silico musculoskeletal modeling

Several studies from the past 10 years have shown a significant subjective benefit after a surgical treatment in comparison to a conservative treatment of a proximal hamstring rupture.4-7 There is also a strong evidence of about 10% decrease in muscle strength in comparison to the non operated site4,13. Similar muscle strength between the operated and contralateral side was observed up to 10 years after repair.14 However, to the best of our knowledge there is a lack of evidence in possible development of biomechanical and functional limb asymmetries including muscle activity caused by these postoperative muscular imbalances. Our project will therefore concentrate on the biomechanics of gait and daily activity tasks and investigate differences between the operated and contralateral limb. Primarily we will quantify potential muscular deficits between limbs and compare these to the findings of the gait pattern. If proven right and limping does occur, it can, on the long run, cause earlier onset of skeletal degeneration and osteoarthritis.8-10 As the mean age of the patients examined in the studies with hamstring rupture is usually about 40 to 45 years6 and the average life expectancy is above 80 years11, potential muscular deficits may manifest as pathological gait that may predispose these patients to premature and potentially more severe degenerative processes. For instance, it is possible that the risk of hip osteoarthritis and/or lower back or iliosacral joint osteoarthritis is higher in patients after a hamstring rupture. Therefore, improving the understanding of biomechanical and functional outcome after hamstring repair is critical, and potential deficits may be prevented with additional physiotherapy addressing muscular imbalances. In the proposed pilot study, we will compile outcome data on the outcome of a new, intraoperative lateral positioning of the anchors on the tuber ischiadicum, as was used in all of our patients, in comparison to regular anatomical anchoring direct on top of the tuber ischiadicum.12 Based on our clinical experience many patients describe a local discomfort in seated position with traditional anchor positioning, and a lateral positioning could potentially prevent this complaint as the lateral area of os ischi is not exposed to the pressure when seated. With this pilot study we will not only provide new insights into the postoperative function of the hamstrings with corresponding gait pattern for the current patients, but also possibly prevent the discomfort while sitting by changing anchor placement in future patients. Further, the data obtained in this study will facilitate proper sample size calculations for future clinical trials.