BIOMECHANICS

MODULE I
Origin: Biomechanics is a branch of biophysics.
Etymology: Bios (means life) + Mechanics
Mechanics is the study of the effect of forces on stationary or moving bodies.
The effect could be mechanical deformation or displacement in stationary
bodies and a change in velocity in moving bodies.
Fluid mechanics is the branch of physics concerned with the mechanics of fluids
(liquids, gases, and plasmas) and the forces on them.
Fluid mechanics can be divided into:
fluid statics, the study of fluids at rest; and
fluid dynamics, the study of the effect of forces on fluid motion.
Solid mechanics, also known as mechanics of solids, is the branch of continuum
mechanics that studies the behavior of solid materials, especially their motion
and deformation under the action of forces, temperature changes, phase
changes, and other external or internal agents.
Continuum mechanics is a branch of mechanics that deals with the mechanical
behavior of materials modeled as a continuous mass rather than as discrete
particles.
Definition: Biomechanics is the study of material properties of tissues in human
and motion of human body parts.
Categories of Biomechanics
 Biofluid mechanics covers the mechanics of human body fluids (Both gas
and liquid). Typical examples for biofluid mechanics are application of
principles of the fluid mechanics to study blood flow, dynamics of the
cardiovascular system and gas transport in respiratory system.
 Biotribology is the study of friction, wear and lubrication of biological
systems especially human joints such as hips and knees.
 Comparative biomechanics is the application of biomechanics to non-
human organisms.
 Computational biomechanics is the application of engineering
computational tools, such as the Finite Element Method (FEM) to study
the mechanics of biological systems.
(Task: Define Computational Biofluid dynamics)
  Experimental biomechanics is the application of experiments and
measurements in biomechanics.
(Task: Try to offer some examples for experimental biomechanics)
 Plant biomechanics refers to the application of biomechanical principles
to plants.
 Sports biomechanics is the application of laws of mechanics to human
movement to understand/rate athletic performance and to avoid/reduce
sport injuries.
Stress-strain
Reading to Stress-Strain Curve: Generally speaking, curves representing the
relationship between stress and strain in any form of deformation can be
regarded as stress-strain curves.
The main characteristic of tissues in the skeletal system is to manifest resistance
to the applied forces. As happens in each object, the absorption of the applied
force results in deformation in the biological tissues. The attributes of
deformation shown by the material under load are evaluated with stress-strain
curve. This evaluation gives us information about the stiffness and strength of
the object. The area below the curve up to the failure of the biological tissue
represents the toughness of the object which is one way to assess strength of the
object, indicating the energy absorbed before the failure. Stiffness is about the
inclination of the curve at elastic deformation stage which is expressed by
Young’s modulus (stress/strain). As Young’s modulus value increases, the
curve becomes steeper and the object becomes stiffer. Depending on the variety
of the terms of stiffness and strength, some objects may be described as stiff and
strong (steel, iron), while some are described as stiff and weak (glass, copper).
Fiberglass and silk are defined as flexible and strong, while spider web and lead
are defined as flexible and weak materials. The bone is a flexible and weak
material as well.
Activity/Question: Comment about the stiffness and the strength of the
materials from the stress-strain curve given above?
Tension compression bending torsion shear
https://www.youtube.com/watch?v=4Am6myjNpEw
Tension: Tension stress (or tensile stress) occurs when two forces pull on an
object in opposite directions so as to stretch it and make it longer and thinner.
The primary load a muscle experiences is a tension load. When the muscle
contracts it pulls on the tendons at both ends, which stretch a little. So the
tendons are under tensile stress.
A tendon or sinew is a tough, high-tensile-strength band of dense fibrous
connective tissue that connects muscle to bone.

Compression: Whether you are sitting or standing, certain structures in your

body are experiencing a compressive load. When you stand, gravity is “pulling
down” on your body while the reaction force of the floor is “pushing up” (for
lack of a simpler way of putting it). So your intervertebral discs and your
sacroiliac joints are experiencing a compressive stress.
The intervertebral disc (IVD) is important in the normal functioning of the
spine. It is a cushion of fibrocartilage and the principal joint between two
vertebrae in the spinal column. There are 23 discs in the human spine: 6 in the
cervical region (neck), 12 in the thoracic region (middle back), and 5 in the
lumbar region (lower back).

The sacroiliac joint connects the hip bones (iliac crests) to the sacrum, the
triangular bone between the lumbar spine and the tailbone (coccyx). The
primary function of the sacroiliac joints is to absorb shock between the upper
body and the pelvis and legs.

Shear: Shear stress is two forces acting parallel to each other but in opposite
directions so that one part of the object is moved or displaced relative to
another part. The best way to visualize shear is to think of how scissors work.
Or better yet, garden shears. Shear causes two objects to slide over one another.
This results, of course, in friction. If one vertebra is being caused to slide
relative to another then there is a shear stress between them.
You undergo shear stress all the time when you walk. Every time you take a
step, for example. As one leg leaves the ground and the other leg takes all your
weight this creates a shear stress in the pelvis because the ground is pushing
up on one side of the body through the supporting leg while gravity is pulling
down on the unsupported side.
Bending: When the spine flexes, the intervertebral discs undergo compressive
stress on the anterior side and tension on the posterior side.
Anterior refers to the ‘front’, and posterior refers to the ‘back’. Putting this in
context, the heart is posterior to the sternum because it lies behind it. Equally,
the sternum is anterior to the heart because it lies in front of it.
Torsion: Torsional loading, which we usually just call torsion, is when forces
acting on a structure cause a twist about its longitudinal axis. This is what
happens in your spine when you twist your body from side to side, for instance.
When you bend laterally to pick up an object in one hand there is a bit of
torsion going on in the spine. Likewise when you carry something heavy in one
hand. Among sports, golf is one big fit of spinal torsion. The stresses that occur
during torsion are much more complex and hard to measure, including shear,
compressive, and tensile stress. Anatomically, due to the facet joint
orientation, the lumbar spine is more susceptible to torsion than the thoracic
which has more tolerance to twisting.
Facet joints are pairs of small joints in between the vertebrae in the back of the
spine. These joints have opposing surfaces of cartilage, which limits friction
between the bones. The joint is surrounded by a capsule filled with a small
amount of synovial fluid.
Thoracic Region = 60 degrees; frontal plane; lateral flexion and rotation; no
flexion/extension
The facet joints between adjacent thoracic vertebrae are angled at 60° to the
transverse plane and 20° to the frontal plane, with the superior facets facing
posterior and a little up and laterally and the inferior facets facing anteriorly,
down, and medially
Lumbar Region = 90 degrees; sagittal plane; only flexion and extension.
The facet joints in the lumbar region lie in the sagittal plane; the articulating
facets are at right angles to the transverse plane and 45° to the frontal plane.
Activity/Question: Write examples for tension, compression, bending, torsion
and shear loads in the locomotory system of the human body?
Constitutive relations
In physics and engineering, a constitutive equation or constitutive relation is a
relation between two physical quantities that is specific to a material or
substance, and approximates the response of that material to external stimuli,
usually as applied fields or forces.

Tensional stress of a uniform bar

Activity/Question: 1) Deduce a mathematical model for the tensional stress of

a uniform bar?
Solid-state deformations (Different types of material models): Classes of
deformations in elastic materials are;
  Elastic: The material recovers its initial shape after deformation.
 Anelastic: The material is close to elastic, but the applied force induces
additional time-dependent resistive forces (i.e. depend on rate of change
of extension/compression, in addition to the magnitude of
extension/compression). Metals and ceramics have this characteristic.
 Viscoelastic: If the time-dependent resistive contributions are large, and
cannot be neglected. Rubbers and plastics have this property, and
certainly do not satisfy Hooke's law. In fact, elastic hysteresis occurs.
 Plastic: The applied force induces non-recoverable deformations in the
material when the stress (or elastic strain) reaches a critical magnitude,
called the yield point.
 Hyperelastic: The applied force induces displacements in the material
following a strain energy density function.
A strain energy density function or stored energy density function is a scalar
valued function that relates the strain energy density of a material to the
deformation gradient.
Activity/Question: Distinguish the properties of Elastic, Anelastic,
Viscoelastic, Plastic and Hyperelastic materials?
Viscoelasticity: Definition and characteristics; viscoelastic material models
The viscosity of a fluid is a measure of its resistance to deformation at a given
rate. For liquids, it corresponds to the informal concept of "thickness": for
example, syrup has a higher viscosity than water.
Viscosity can be conceptualized as quantifying the internal frictional force that
arises between adjacent layers of fluid that are in relative motion.
In physics and materials science, elasticity is the ability of a body to resist a
distorting influence and to return to its original size and shape when that
influence or force is removed. Solid objects will deform when adequate loads
are applied to them; if the material is elastic, the object will return to its initial
shape and size after removal. This is in contrast to plasticity, in which the object
fails to do so and instead remains in its deformed state.
In materials science and continuum mechanics, viscoelasticity is the property of
materials that exhibit both viscous and elastic characteristics when undergoing
deformation. Viscous materials, like water, resist shear flow and strain linearly
with time when a stress is applied.
The term shear flow is used in solid mechanics as well as in fluid dynamics. The
term ‘shear flow’ is used to indicate:
  A shear stress over a distance in a thin-walled structure (in solid
mechanics)
 The flow induced by a force (in a fluid)
Viscoelastic materials, such as amorphous polymers, semi-crystalline polymers,
biopolymers and even the living tissue and cells, can be modeled in order to
determine their stress and strain or force and displacement interactions as well
as their temporal dependencies. These models, which include the Maxwell
model, the Kelvin–Voigt model, the standard linear solid model, and the
Burgers model, are used to predict a material's response under different loading
conditions.
Activity/Questions: 1) Differentiate elastic and viscoelastic materials with the
help of stress-strain curves?
2) Model the time-dependent stress response of a biomaterial using Maxwell’s
approach?
https://www.youtube.com/watch?v=csy3QwIg7p4
https://www.youtube.com/watch?v=9gPc_yPFngk
https://www.youtube.com/watch?v=puFe0fHsCz0
Theory of failure
https://nptel.ac.in/content/storage2/courses/112105125/pdf/Module-3_lesson-
1.pdf
 Maximum principal stress theory (Rankine theory)
 Maximum principal strain theory (St. Venant’s theory)
 Maximum shear stress theory (Tresca theory)
 Maximum strain energy theory (Beltrami’s theory)
 Distortion energy theory( von Mises yield criterion)
Activity/Questions: List various theories of failure?
MODULE II
Human Joints
Joint: A joint or articulation (or articular surface) is the connection made
between bones in the body which link the skeletal system into a functional
whole.
Generic Anatomy of a Joint
Cartilage. This is a type of tissue that covers the surface of a bone at a joint.
Cartilage helps reduce the friction of movement within a joint.
Synovial membrane. A tissue called the synovial membrane lines the joint and
seals it into a joint capsule. The synovial membrane secretes a clear, sticky
fluid (synovial fluid) around the joint to lubricate it.
Ligaments. Strong ligaments (tough, elastic bands of connective tissue)
surround the joint to give support and limit the joint's movement. Ligaments
connect bones together.
Tendons. Tendons (another type of tough connective tissue) on each side of a
joint attach to muscles that control movement of the joint. Tendons connect
muscles to bones.
Bursas. Fluid-filled sacs, called bursas, between bones, ligaments, or other
nearby structures. They help cushion the friction in a joint.
Synovial fluid. A clear, sticky fluid secreted by the synovial membrane.
Meniscus. This is a curved part of cartilage in the knees and other joints.

Activity/Question: 1) With the help of a neat diagram of the hip joint discuss
the generic anatomy of joints in human body?
2) Differences in the compositions of Bursas and Synovial fluid?
What are the Similarities Between Bursa and Synovial Fluid?
 Both bursa and synovial fluid are shock absorbers.
 Bursae are filled with synovial fluids.
 They help reduce friction between bones in a joint.
What is the Difference Between Bursa and Synovial Fluid?
Bursae are tiny fluid-filled sacs which facilitate gliding movements of tendons,
ligaments, muscles, and skin over bones during joint movement while synovial
fluid is the fluid that fills the synovial cavity of the synovial joint. So, this is the
key difference between bursa and synovial fluid. Besides, bursae are found
around tendons, ligaments, muscles, and skin moving across a bony surface
while synovial fluid is located within the synovial cavity of a synovial joint.
Moreover, structurally, bursae are small fluid-filled sacs while synovial fluid is
a viscous, slippery, lubricating fluid. Hence, this is the structural difference
between bursa and synovial fluid.
Also, functionally, bursae provide a cushion between bones and tendons and/or
muscles around a joint and reduce the friction between bones when moving
while synovial fluid help in lubrication, nutrient distribution and shock
absorption.
Classifications of joints
 Structural classification (based on the binding tissue)
 Functional classification (based on the movement)
Structural classification (based on the binding tissue): Structural classification
names and divides joints according to the type of binding tissue that connects
the bones to each other. There are four structural classifications of joints:
 Fibrous joint – joined by dense regular connective tissue that is rich in
collagen fibers
 Cartilaginous joint – joined by cartilage.
 Synovial joint – not directly joined – the bones have a synovial cavity
and are united by the dense irregular connective tissue that forms the
articular capsule that is normally associated with accessory ligaments.
 Facet joint – joint between two articular processes between two
vertebrae.
Process: In anatomy, a process is a projection or outgrowth of tissue from a
larger body. For instance, in a vertebra, a process may serve for muscle
attachment and leverage (as in the case of the transverse and spinous processes),
or to fit (forming a synovial joint), with another vertebra (as in the case of the
articular processes).
Functional classification (based on the movement)
Joints can also be classified functionally according to the type and degree of
movement they allow.
 Synarthrosis – permits little or no mobility. Most synarthrosis joints are
fibrous joints (e.g., skull sutures).
 Amphiarthrosis – permits slight mobility. Most amphiarthrosis joints are
cartilaginous joints (e.g., intervertebral discs).
 Synovial joint (also known as a diarthrosis) – freely movable.
Synovial joints can in turn be classified into six groups according to the type
of movement they allow:
 Plane joint
 Ball and socket joint
 Hinge joint
 Pivot joint
 Condyloid joint
 Saddle joint
Plane Joint: A plane joint (arthrodial joint, gliding joint, plane articulation) is
a synovial joint which, under physiological conditions, allows only gliding
movement.
Ball and socket joint: The ball and socket joint (or spheroid joint) is a type of
synovial joint in which the ball-shaped surface of one rounded bone fits into the
cup-like depression of another bone.
Hinge joint: A hinge joint (ginglymus or ginglymoid) is a bone joint in which
the articular surfaces are molded to each other in such a manner as to permit
motion only in one plane. According to one classification system they are said
to be uniaxial. The best examples of ginglymoid joints are the Interphalangeal
joints of the hand and those of the foot and the joint between the humerus and
ulna.
The interphalangeal joints of the hand are the hinge joints between the
phalanges of the fingers that provide flexion towards the palm of the hand.

The humerus is a long bone in the arm that runs from the shoulder to the elbow.

The ulna is a long bone found in the forearm that stretches from the elbow to
the smallest finger, and when in anatomical position, is found on the medial side
of the forearm. It runs parallel to the radius, the other long bone in the forearm.
Pivot joint: In animal anatomy, a pivot joint (trochoid joint, rotary joint or
lateral ginglymus) is a type of synovial joint whose movement axis is parallel
to the long axis of the proximal bone, which typically has a convex articular
surface. Eg. Proximal radioulnar articulation (synovial pivot joint between the
circumference of the head of the radius and the ring formed by the radial notch
of the ulna and the annular ligament).
Condyloid joint: A condyloid joint (also called condylar, ellipsoidal, or
bicondylar) is an ovoid articular surface, or condyle that is received into an
elliptical cavity. This permits movement in two planes, allowing flexion,
extension, adduction, abduction, and circumduction. Eg. Wrist joint
Saddle joint: A saddle joint (sellar joint) is a type of synovial joint in which the
opposing surfaces are reciprocally concave and convex. It is found in the
thumb, the thorax, the middle ear, and the heel.
Activity/Questions: Draw a tree diagram that clearly demonstrates the
classification of various joints in the human body? Draw the schematic of
different types of synovial joints in the human body? Write at least one example
for each type of joint in the human body (Preferably in a table)?
Anatomical terms of motion
Flexion describes a bending movement that decreases the angle between a
segment and its proximal segment.
Extension is the opposite of flexion, describing a straightening movement that
increases the angle between body parts.
Hyperextension is any extension that goes beyond 180 degrees and becomes
reflexive.

Abduction is a motion that pulls a structure or part away from the midline of
the body.
Adduction is a motion that pulls a structure or part towards the midline of the
body, or towards the midline of a limb.
Elevation is movement in a superior direction.
Depression is movement in an inferior direction, the opposite of elevation.
Internal rotation (medial rotation or intorsion) is rotation towards the axis of
the body.
External rotation (lateral rotation or extorsion) is rotation away from the
center of the body.
 Rotating the arm away from the body is external rotation.

 Rotating the arm closer to the body is internal rotation.

Related Terms
 Anterograde and retrograde flow refer to movement of blood or other
fluids in a normal (anterograde) or abnormal (retrograde) direction.
 Circumduction is a conical movement of a body part, such as a ball and
socket joint or the eye. Circumduction is a combination of flexion,
extension, adduction and abduction.
 Reduction is a motion returning a bone to its original state, such as a
shoulder reduction following shoulder dislocation, or reduction of a
hernia.
 A version is an eye movement involving both eyes moving
synchronously and symmetrically in the same direction.
 Torsion is eye movement that affects the vertical axis of the eye, such as
the movement made when looking in to the nose.
Eversion of the right foot and Inversion of the right foot
Occlusion is motion of the mandibula towards the maxilla making contact
between the teeth.

Protrusion and retrusion are sometimes used to describe the anterior

(protrusion) and posterior (retrusion) movement of the jaw.
Activity/Questions: With neat schematic diagrams demonstrate anatomical
terms of motion?
GAIT
Definition: The term gait refers to a pattern of limb movements made during
human locomotion. Simply the manner or style of walking.
Diagnostic Significance of Analyzing the Gait: Human gait depends on a
complex interplay of major parts of the nervous, musculoskeletal and
cardiorespiratory systems.
The individual gait pattern is influenced by age, personality, mood and
sociocultural factors.
The preferred walking speed in older adults is a sensitive marker of general
health and survival.
Safe walking requires intact cognition and executive control.
Gait disorders lead to a loss of personal freedom, falls and injuries and result in
a marked reduction in the quality of life.
An analysis of phases of ambulation is an essential part of the diagnosis of
various neurologic disorders and the assessment of patient progress during
rehabilitation and recovery from the effects of neurologic disease, a
musculoskeletal injury or disease process, or amputation of a lower limb.
Gait disorders and Causes?
Gait is a person’s pattern of walking. Walking involves balance and
coordination of muscles so that the body is propelled forward in a rhythm,
called the stride. There are numerous possibilities that may cause an abnormal
gait. Some common causes are:
 A degenerative disease (such as arthritis)
 An inner ear disorder
 Stroke
 Foot conditions
 A neurologic condition
 Something as simple as ill-fitting shoes
Types of Gate Disorders
 Propulsive gait
 Scissors gait
 Spastic gait
 Steppage gait
 Waddling gait
Propulsive gait: This type of gait is seen in patients with parkinsonism. It is
characterized by a stooping (bend one's head or body forwards and downwards),
rigid posture, and the head and neck are bent forward. Steps tend to become
faster and shorter.
Please Watch this video
https://www.youtube.com/watch?v=7SyTpEdhBLw
Scissors gait: This type of gait gets its name because the knees and thighs hit or
cross in a scissors-like pattern when walking. The legs, hips, and pelvis become
flexed, making the person appear as though he or she is crouching (adopt a
position where the knees are bent and the upper body is brought forward and
down, typically in order to avoid detection or to defend oneself). The steps are
slow and small. This type of gait occurs often in patients with spastic cerebral
palsy.
Please Watch this video
https://www.youtube.com/watch?v=_fid_VHpXbI
Spastic cerebral palsy is the most common type of cerebral palsy. The muscles
of people with spastic cerebral palsy feel stiff and their movements may look
stiff and jerky. Spasticity is a form of hypertonia, or increased muscle tone. This
results in stiff muscles which can make movement difficult or even impossible.
Cerebral palsy (CP) is a group of disorders that affect a person's ability to move
and maintain balance and posture. CP is the most common motor disability in
childhood. Cerebral means having to do with the brain. Palsy means weakness
or problems with using the muscles.
Muscle Tone: In physiology, medicine, and anatomy, muscle tone (residual
muscle tension or tonus) is the continuous and passive partial contraction of the
muscles, or the muscle's resistance to passive stretch during resting state. It
helps to maintain posture and declines during Rapid Eye Movement (REM)
sleep. If a sudden pull or stretch occurs, the body responds by automatically
increasing the muscle's tension, a reflex which helps guard against danger as
well as helping maintain balance. Such near-continuous innervation can be
thought of as a "default" or "steady state" condition for muscles. Both the
extensor and flexor muscles are involved in the maintenance of a constant tone
while at rest. In skeletal muscles, this helps maintain a normal posture.
Spastic gait: Common to patients with cerebral palsy or multiple sclerosis (In
MS, the immune system attacks the protective sheath (myelin) that covers nerve
fibers and causes communication problems between your brain and the rest of
your body.), spastic gait is a way of walking in which one leg is stiff and drags
in a semicircular motion on the side most affected by long-term muscle
contraction.
Steppage gait: A “high stepping” type of gait in which the leg is lifted high, the
foot drops (appearing floppy), and the toes points downward, scraping the
ground, when walking. Peroneal muscle atrophy or peroneal nerve injury, as
with a spinal problem (such as spinal stenosis or herniated disc), can cause this
type of gait.
Word meaning of floppy: Something that is floppy is loose rather than stiff, and
tends to hang downwards.
The peroneus muscles (also called fibularis muscles or peroneals or peronaeus)
are a group of muscles in the leg. While the muscle group exists in many
variations, it is normally composed of three muscles: peroneus longus, brevis
and tertius.

Spinal stenosis is a narrowing of the spaces within your spine, which can put
pressure on the nerves that travel through the spine. Spinal stenosis occurs most
often in the lower back and the neck. Some people with spinal stenosis may not
have symptoms.

Spinal disc herniation is an injury to the cushioning and connective tissue

between vertebrae, usually caused by excessive strain or trauma to the spine. It
may result in back pain, pain or sensation in different parts of the body, and
physical disability.
Word meaning of hernia: a condition in which part of an organ is displaced and
protrudes through the wall of the cavity containing it.
Waddling gait: Movement of the trunk is exaggerated to produce a waddling,
duck-like walk. Progressive muscular dystrophy or hip dislocation present from
birth can produce a waddling gait.
Word meaning of Waddling: Walk with short steps and a clumsy (awkward)
swaying motion (move slowly or rhythmically backwards and forwards or from
side to side).
Trunk or torso is an anatomical term for the central part of the human body
from which extend the neck and limbs. The trunk includes the thorax and
abdomen.

Muscular dystrophy is a group of diseases that cause progressive weakness and

loss of muscle mass. In muscular dystrophy, abnormal genes (mutated) interfere
with the production of proteins needed to form healthy muscle.
While muscular dystrophy can cause muscle atrophy, they are not the same
condition. Muscular dystrophy is a genetic condition encompassing nine main
types, while muscle atrophy refers to the loss of muscle tissue. Muscle atrophy
can often be reversed with treatments and exercise.
Watch the video in the link below
https://stanfordmedicine25.stanford.edu/the25/gait.html
Activity/Question: How the Gate patters of Parkinsonism, Spastic cerebral
palsy, multiple sclerosis, spinal stenosis or herniated disc and Progressive
muscular dystrophy can be distinguished?
Phases of the Gait Cycle (8 phase model):
 Initial Contact
 Loading Response
 Midstance
 Terminal Stance
 Pre-swing
 Initial Swing
 Mid Swing
 Late Swing

https://www.physio-pedia.com/Gait
https://www.youtube.com/watch?v=1u6d1CX7o9c
https://www.youtube.com/watch?v=PZBiv0uSXVg
Activity/Question: Draw a neat diagram that clearly demonstrates various
phases of the Gait cycle?
Spatial Gait Parameters
Looking at gait from a spatial perspective allows us to measure gait
asymmetries related to distance between steps and strides lengths. Some typical
spatial gait parameters are: step length, stride length, step width and foot angle.
 Step length is the length measured parallel to the Line of Progression of
the body, from the posterior contact (heel) of the previous footfall to the
posterior contact (heel) of the current opposing footfall.
 Stride length is the distance measured parallel to the Line of Progression,
between the Posterior Heel points of two consecutive footprints of the foot in
question
 Step width is the distance measured between line of progression of the
left foot and the line of progression of the right foot.
 Foot angle is the angle between the line of progression and the foot axis.
Foot Angle is zero when the foot axis is parallel to the line of progression. The
Foot Angle is positive when the foot axis points lateral to the line of
progression. The Foot Angle is negative when the foot axis points medial to
the line of progression.
Other timing variables can be calculated from this information, step time, stride
velocity and step length to leg length ratio. This can be calculated from the leg
length of the patient.

Activity/Question: 1) Define the spatial and temporal Gait parameters based on

the figures given above?
2) Propose a medical protocol that is useful for differentiating abnormal Gait
patterns from spatial and temporal parameters?
Instrumentation for gait analysis: Measurement devices
Footswitches
https://www.rehab.research.va.gov/mono/gait/bontrager.pdf
https://www.motion-labs.com/prod_access_footswitches.html
Instrumented walkway
https://www.gaitrite.com/
https://www.protokinetics.com/zeno-walkway/
https://www.nupoc.northwestern.edu/docs/news/instrumented-walkwaysCR.pdf
A company
https://summitmedsci.co.uk/products/
Goniometers

A goniometer is an instrument that measures the available range of motion at a

joint. The art and science of measuring the joint ranges in each plane of the joint
are called goniometry. If a patient or client is suffering from decreased range of
motion in a particular joint, the therapist can use a goniometer to assess what
the range of motion is at the initial assessment, and then make sure the
intervention is working by using the goniometer in subsequent sessions.
Goniometer has different types; the most used is the universal standard
goniometer, which is either made with plastic or metal tool. It consists of a
stationary arm, a movable arm, and a fulcrum. Other types of goniometer used
for joint range of motion measurement are the telescopic-armed goniometer and
some smartphone applications.
https://www.youtube.com/watch?v=ZUF7tpkVAIY
Pedobarography
Pedobarography is the study of pressure fields acting between the plantar
surface of the foot and a supporting surface. The data generated by all modern
technologies is either a 2D image or a 2D image time series of the pressures
acting under the plantar surface of the foot.

The most widely researched clinical application of pedobarography is to spot

plantar locations that has the risk of diabetic foot ulceration. It is a condition
which can lead to amputation in extreme cases but for which even mild-to-
moderate cases are associated with substantial health care expenditure.
Pedobarography is also used in a variety of other clinical situations including
the design of orthotics and footwear.
https://www.wbaltv.com/article/womans-doctor-new-machine-gauges-foot-
pressure/31280394
Force platforms
Force platforms or force plates are measuring instruments that measure the
ground reaction forces generated by a body standing on or moving across them,
to quantify balance, gait and other parameters of biomechanics.
Activity/Question: Compare the clinical applications of Goniometers,
Pedobarographs and Force platforms?
E-books and Reference Materials
http://www.profedf.ufpr.br/rodackibiomecanica_arquivos/Books/Duane
%20Knudson-%20Fundamentals%20of%20Biomechanics%202ed.pdf
https://www.physio-pedia.com/Introduction_to_Human_Biomechanics_-
_Internal_Forces
https://chiro.org/ACAPress/Biomechanics_Joint_Stability.html
http://cloudportal.sathyabama.ac.in/coursematerial_staging/uploads/SBMA1403
.pdf
UNIT III
Cardiovascular Mechanics
Biofluid dynamics: Biofluid dynamics may be considered as the discipline of
biological engineering or biomedical engineering in which the fundamental
principles of fluid dynamics are used to explain the mechanisms of biological
flows and their interrelationships with physiological processes, in health and in
diseases/disorder. It can be considered as the conjuncture of mechanical
engineering and biological engineering.
A fluid is defined as a substance that deforms continuously under application
of a shearing stress, regardless of how small the stress is. Blood is a primary
example of a biological fluid. Air can also be considered as biological fluid as it
flows in lungs and the synovial fluid between the knee joints is also an example
of a biological fluid.
Types of Fluids: Fluids can be classified into four basic types. They are:
 Ideal Fluid
 Real Fluid
 Newtonian Fluid
 Non-Newtonian fluid
Ideal Fluid: An Ideal Fluid is a fluid that has no viscosity, means it will offer
no resistance, pragmatically this type of fluid does not exist. It is
incompressible in nature.
Real fluids are compressible in nature. They offer some resistance and thus
have viscosity. All Fluids existing are real fluids.
Newtonian Fluid: A Newtonian Fluid is a fluid whose viscous shear stresses
(acting between different layers of fluid and between the fluid layer and surface
over which it is flowing) are directly proportional to the rate of change of
velocity of the flow of the fluid with respect to the distance in the transverse
direction (distance measured perpendicular to the flow), also known as velocity
gradient. The constant of proportionality is known as the dynamic viscosity of
the fluid denoted by 'μ'. The functional relationship between viscous shear stress
and velocity gradient is linear in a Newtonian fluid. This relationship may be
written as:

Non-Newtonian fluid: The viscosity of non-Newtonian fluids is dependent on

shear rate. In a non-Newtonian fluids, a constant coefficient of viscosity cannot
be defined as the viscosity varies with time.
Non-Newtonian fluids change their viscosity or flow behavior under stress. If a
stress is applied to such fluids, the sudden application of stress can cause them
to get thicker and act like a solid, or in some cases, it results in the opposite
behavior and they may get runnier than they were before. Removal of the
stress causes them to return to their earlier state. Not all non-Newtonian Fluids
behave in the same way when stress is applied – some become more solid,
others more fluid. Some non-Newtonian fluids react as a result of the amount
of stress applied, while others react as a result of the length of time that stress
is applied. The generalized power law for all fluids can be written as:

Thixotropic Fluid: Its viscosity decreases with stress over time. Example -
Honey – keep stirring, and solid honey becomes liquid.
Rheopectic Fluid: Its viscosity increases with stress over time. Example -
Cream – the longer it is whipped, the thicker it gets.
Shear Thinning Fluid: Its viscosity decreases with increased stress. Example –
Blood, Tomato sauce.
Dilatant or shear thickening Fluid: Its viscosity increases with increased
stress. Example – Oobleck (a mixture of cornstarch and water), Quicksand.
A Bingham plastic is neither a fluid nor a solid. A Bingham plastic can
withstand a finite shear load and flow like a fluid when that shear stress is
exceeded. Tooth paste and mayonnaise are examples of Bingham plastics.
Blood is also a Bingham plastic and behaves as a solid at shear rates very
close to zero. The yield stress for blood is very small, approximately in the
range from 0.005 to 0.01 N/m2.
Yield stress refers to the minimum stress at which a material will deform
without significant increase in load.

Reynolds number of the flow is defined as the ratio of inertia forces to viscous
forces. Mathematically it is written as,

The Reynolds number helps us to predict the transition between laminar and
turbulent flows. Laminar flow is highly organized flow along streamlines. As
velocity increases, flow can become disorganized and chaotic. This is known as
turbulent flow. Laminar flow occurs in flow environments where Re < 2000.
Turbulent flow is present in circumstances under which Re > 4000. The range
of 2000 < Re < 4000 is known as the transition range. Most blood flow in
humans is laminar, having a Re of 300 or less, it is possible for turbulence to
occur at very high flow rates in the descending aorta, for example, in highly
conditioned athletes. Turbulence is also common in pathological conditions
such as heart murmurs and stenotic heart valves. Stenotic comes from the
Greek word "stenos," meaning narrow. Stenotic means narrowed, and a stenotic
heart valve is one in which the narrowing of the valve is a result of the plaque
formation on the valve.
Womersley number: The Womersley number, or alpha parameter, is another
parameter like the Reynolds number that has been used in the study of fluid
dynamics. This parameter represents a ratio of transient to viscous forces, just
as the Reynolds number represented a ratio of inertial to viscous forces. The
Womersley number may be written as,

Functioning of Human Heart

The study of the blood flow is called hemodynamics. The study of the
properties of the blood flow is called hemorheology.
Cardiac output: the heart is the driver of the circulatory system, pumping blood
through rhythmic contraction and relaxation. The rate of blood flow out of the
heart (often expressed in L/min) is known as the cardiac output (CO).
In a normal circulatory system, the volume of blood returning to the heart each
minute is approximately equal to the volume that is pumped out each minute
(the cardiac output). Because of this, the velocity of blood flow across each
level of the circulatory system is primarily determined by the total cross-
sectional area of that level. This is mathematically expressed by the following
equation:
Turbulence: Blood flow is also affected by the smoothness of the vessels,
resulting in either turbulent (chaotic) or laminar (smooth) flow. Smoothness is
reduced by the buildup of fatty deposits on the arterial walls. The Reynolds
number (denoted NR or Re) is a relationship that helps determine the behavior
of a fluid in a tube, in this case blood in the vessel. The equation for this
dimensionless relationship is written as:

The Reynolds number is directly proportional to the velocity and diameter of

the tube. Note that NR is directly proportional to the mean velocity as well as
the diameter. A Reynolds number of less than 2300 is laminar fluid flow, which
is characterized by constant flow motion, whereas a value of over 4000, is
represented as turbulent flow. Due to its smaller radius and lowest velocity
compared to other vessels, the Reynolds number at the capillaries is very low,
resulting in laminar instead of turbulent flow.
Velocity: Often expressed in cm/s. This value is inversely related to the total
cross-sectional area of the blood vessel and also differs per cross-section,
because in normal condition the blood flow has laminar characteristics. For
this reason, the blood flow velocity is the fastest in the middle of the vessel and
slowest at the vessel wall. In most cases, the mean velocity is used. Blood
velocities in arteries are higher during systole than during diastole. One
parameter to quantify this difference is the pulsatility index (PI), which is
equal to the difference between the peak systolic velocity and the minimum
diastolic velocity divided by the mean velocity during the cardiac cycle. This
value decreases with distance from the heart.

Vascular resistance:
 Hagen–Poiseuille (HP) equation
 Thurston’s Model
Resistance is also related to vessel radius, vessel length, and blood viscosity. In
a first approach based on fluids, as indicated by the Hagen–Poiseuille equation.

In a second approach, more realistic of the vascular resistance and coming from
experimental observations on blood flows, according to Thurston, there is a
plasma release-cell layering at the walls surrounding a plugged flow. It is a
fluid layer in which at a distance δ, viscosity η is a function of δ written as
η(δ), and these surrounding layers do not meet at the vessel centre in real
blood flow. Instead, there is the plugged flow which is hyper-viscous because
holding high concentration of RBCs. Thurston assembled this layer to the flow
resistance to describe blood flow by means of a viscosity η(δ) and thickness δ
from the wall layer. The blood resistance law appears as R adapted to blood
flow profile,

Wall tension: Regardless of site, blood pressure is related to the wall tension
of the vessel according to the Young–Laplace equation (assuming that the
thickness of the vessel wall is very small as compared to the diameter of the
lumen):
Questions/Activities: 1) With the help of neat sketches and supporting
mathematical models, analyse how the Wall tension, Cylinder stress,
Vascular resistance, Pulsatility Index and Reynolds number are helpful to
describe the dynamics of cardiovascular system in human?
2) What are the types of fluids? Compare the mathematical models
governing the Non-Newtonian and Newtonian fluids?
3) With the help of a neat diagram describe the circulatory system in
human?
Further Reading: https://en.wikipedia.org/wiki/Hemorheology
Hard Tissue: Hard tissue (also termed calcified tissue) is tissue which is
mineralized and has a firm intercellular matrix.
Mineralized tissues are biological tissues that incorporate minerals into soft
matrices.
In biology, the extracellular matrix (ECM) is a three-dimensional network
consisting of extracellular macromolecules and minerals, such as collagen,
enzymes, glycoproteins and hydroxyapatite that provide structural and
biochemical support to surrounding cells. Glycoproteins are proteins which
contain oligosaccharide chains (glycans) covalently attached to amino acid
side-chains. Hydroxyapatite, also called hydroxylapatite (HA), is a naturally
occurring mineral form of calcium apatite (Apatite is a group of phosphate
minerals).
The hard tissues of humans are;
 Bone
 Tooth enamel
 Dentin
 Cementum
The term is in contrast to soft tissue.
Bone is a rigid organ that constitutes part of the vertebral skeleton. Bones
support and protect the various organs of the body, produce red and white
blood cells, store minerals and also enable mobility. Bone tissue is a type of
dense connective tissue. Bones come in a variety of shapes and sizes and have a
complex internal and external structure. They are lightweight yet strong and
hard, and serve multiple functions. Mineralized osseous tissue or bone tissue,
is of two types – cortical and cancellous and gives it rigidity and a coral-like
three-dimensional internal structure. Other types of tissue found in bones
include marrow, endosteum, periosteum, nerves, blood vessels and cartilage.
The endosteum (plural endostea) is a thin vascular membrane of connective
tissue that lines the inner surface of the bony tissue that forms the medullary
cavity of long bones. The medullary cavity (medulla, innermost part) is the
central cavity of bone shafts where red bone marrow and/or yellow bone
marrow (adipose tissue) is stored; hence, the medullary cavity is also known as
the marrow cavity. The periosteum is a membrane that covers the outer
surface of all bones, except at the articular surfaces (i.e. the parts within a
joint space) of long bones.
Bone is an active tissue composed of different cells. Osteoblasts are involved in
the creation and mineralisation of bone; osteocytes and osteoclasts are
involved in the reabsorption of bone tissue. The mineralised matrix of bone
tissue has an organic component mainly of collagen and an inorganic
component of bone mineral made up of various salts.
Osteoblasts are cells with a single nucleus that synthesize bone. However, in
the process of bone formation, osteoblasts function in groups of connected cells.
Individual cells cannot make bone. A group of organized osteoblasts together
with the bone made by a unit of cells is usually called the osteon. Osteoblasts
are specialized, terminally differentiated products of mesenchymal stem cells.
They synthesize dense, crosslinked collagen and specialized proteins in much
smaller quantities, including osteocalcin and osteopontin, which compose the
organic matrix of bone.
An osteocyte, an oblate shaped type of bone cell with dendritic processes, is the
most commonly found cell in mature bone tissue, and can live as long as the
organism itself. An osteoclast is a type of bone cell that breaks down bone
tissue. This function is critical in the maintenance, repair, and remodelling of
bones of the vertebral skeleton. The osteoclast disassembles and digests the
composite of hydrated protein and mineral at a molecular level by secreting
acid and a collagenase, a process known as bone resorption. This process also
helps regulate the level of blood calcium. Bone resorption is resorption of bone
tissue, that is, the process by which osteoclasts break down the tissue in bones
and release the minerals, resulting in a transfer of calcium from bone tissue
to the blood.
Collagen is the main structural protein in the extracellular matrix found in the
body's various connective tissues. As the main component of connective tissue,
it is the most abundant protein in mammals, making up from 25% to 35% of the
whole-body protein content. Collagen consists of amino acids bound together
to form a triple helix of elongated fibril known as a collagen helix. It is mostly
found in connective tissue such as cartilage, bones, tendons, ligaments, and
skin.
Enamel: Enamel is the hardest substance in the human body and contains the
highest percentage of minerals, 96%, with water and organic material
composing the rest. The primary mineral is hydroxyapatite, which is a
crystalline calcium phosphate. Enamel is found in the tooth. The large amount
of mineral in enamel accounts not only for its strength but also for its
brittleness. Enamel does not contain collagen, as found in other hard tissues
such as dentin and bone, but it does contain two unique classes of proteins:
amelogenins and enamelins.
Dentin: By weight, 70% of dentin consists of the mineral hydroxyapatite, 20%
is organic material, and 10% is water. Dentin, which is less mineralized and
less brittle than enamel, is necessary for the support of enamel.
Cementum: Cementum is slightly softer than dentin and consists of about 45%
to 50% inorganic material (hydroxyapatite) by weight and 50% to 55% organic
matter and water by weight. The organic portion is composed primarily of
collagen and proteoglycans. Cementum is avascular, receiving its nutrition
through its own imbedded cells from the surrounding vascular periodontal
ligament. Cementum on the root ends surrounds the apical foramen and may
extend slightly onto the inner wall of the pulp canal.
Apical foramen: In dental anatomy, the apical foramen, literally translated
"small opening of the apex," is the tooth's natural opening, found at the root's
very tip—that is, the root's apex—whereby an artery, vein, and nerve enter the
tooth and commingle with the tooth's internal soft tissue, called pulp.
Additionally, the apical foramen is the point where the pulp meets the
periodontal tissues (the connective tissues that surround and support the
tooth).

1. Tooth 2. Enamel 3. Dentin 4. Dental pulp 5. Cameral pulp 6. Root pulp 7.

Cementum 8. Crown 9. Cusp 10. Sulcus 11. Neck 12. Root 13. Furcation 14.
Root apex 15. Apical foramen 16. Gingival sulcus 17. Periodontium 18.
ingiva19. Free or interdental 20. Marginal 21. Alveolar 22. Periodontal ligament
23. Alveolar bone 24. Vessels and nerves 25. Dental 26. Periodontal 27.
Alveolar through channel
Structure of Bone: Bone is not uniformly solid, but consists of a flexible
matrix (about 30%) and bound minerals (about 70%) which are intricately
woven and endlessly remodeled by a group of specialized bone cells. Their
unique composition and design allows bones to be relatively hard and strong,
while remaining lightweight. Bone matrix is 90 to 95% composed of elastic
collagen fibers, also known as ossein, and the remainder is ground substance.
The elasticity of collagen improves fracture resistance. The matrix is hardened
by the binding of inorganic mineral salt, calcium phosphate, in a chemical
arrangement known as calcium hydroxylapatite. It is the bone mineralization
that give bones rigidity. Bone is actively constructed and remodeled throughout
life by special bone cells known as osteoblasts and osteoclasts. Within any
single bone, the tissue is woven into two main patterns, known as cortical and
cancellous bone, and each with different appearance and characteristics.
Cortex: The hard outer layer of bones is composed of cortical bone, which is
also called compact bone as it is much denser than cancellous bone. It forms
the hard exterior (cortex) of bones. The cortical bone gives bone its smooth,
white, and solid appearance, and accounts for 80% of the total bone mass of an
adult human skeleton. It facilitates bone's main functions—to support the
whole body, to protect organs, to provide levers for movement, and to store and
release chemical elements, mainly calcium. It consists of multiple microscopic
columns, each called an osteon or Haversian system. Each column is multiple
layers of osteoblasts and osteocytes around a central canal called the
Haversian canal. Volkmann's canals at right angles connect the osteons
together. The columns are metabolically active, and as bone is reabsorbed and
created the nature and location of the cells within the osteon will change.
Cortical bone is covered by a periosteum on its outer surface, and an
endosteum on its inner surface. The endosteum is the boundary between the
cortical bone and the cancellous bone. The primary anatomical and functional
unit of cortical bone is the osteon.
Cancellous bone/Trabecules: The words cancellous and trabecular refer to the
tiny lattice-shaped units (trabeculae) that form the tissue. Cancellous bone,
also called trabecular or spongy bone, is the internal tissue of the skeletal bone
and is an open cell porous network. Cancellous bone has a higher surface-area-
to-volume ratio than cortical bone and it is less dense. This makes it weaker and
more flexible. The greater surface area also makes it suitable for metabolic
activities such as the exchange of calcium ions. Cancellous bone is typically
found at the ends of long bones, near joints and in the interior of vertebrae.
Cancellous bone is highly vascular and often contains red bone marrow where
hematopoiesis, the production of blood cells, occurs. Thin formations of
osteoblasts covered in endosteum create an irregular network of spaces,
known as trabeculae. Within these spaces are bone marrow and
hematopoietic stem cells that give rise to platelets, red blood cells and white
blood cells. Trabecular marrow is composed of a network of rod- and plate-like
elements that make the overall organ lighter and allow room for blood vessels
and marrow. Trabecular bone accounts for the remaining 20% of total bone
mass but has nearly ten times the surface area of compact bone.
Marrow: Bone marrow, also known as myeloid tissue in red bone marrow, can
be found in almost any bone that holds cancellous tissue.
Composition of Bone: Bones consist of living cells (osteoblasts and osteocytes)
embedded in a mineralized organic matrix. The primary inorganic component
of human bone is hydroxyapatite, the dominant bone mineral, having the
nominal composition of Ca10(PO4)6(OH)2. The organic components of this
matrix consist mainly of type I collagen—"organic" referring to materials
produced within the human body—and inorganic components, which alongside
the dominant hydroxyapatite phase, include other compounds of calcium and
phosphate including salts. Approximately 30% of the acellular component of
bone consists of organic matter, while roughly 70% by mass is attributed to the
inorganic phase. The collagen fibers give bone its tensile strength, and the
interspersed crystals of hydroxyapatite give bone its compressive strength.
Type I collagen composes 90–95% of the organic matrix, with remainder of
the matrix being a homogenous liquid called ground substance consisting of
proteoglycans such as hyaluronic acid and chondroitin sulfate, as well as
non-collagenous proteins such as osteocalcin, osteopontin or bone
sialoprotein. Collagen consists of strands of repeating units, which give bone
tensile strength, and are arranged in an overlapping fashion that prevents shear
stress. Two types of bone can be identified microscopically according to the
arrangement of collagen: woven and lamellar.
Activity/Questions: 1) Identify the aspects that distinguishes structures like
Bone, Tooth enamel, Dentin and Cementum?
2) List various types of cells that constitute the bones? Distinguish them in
terms of morphological and physiological aspects?
3. Discuss the structure and composition of bones?
Hard tissue
Soft tissue
https://en.wikipedia.org/wiki/Soft_tissue
https://en.wikipedia.org/wiki/Davis%27s_law
Bone
https://en.wikipedia.org/wiki/Bone
https://www.physio-pedia.com/Bone
https://www.urmc.rochester.edu/encyclopedia/content.aspx?
ContentTypeID=85&ContentID=P00109
https://musculoskeletalkey.com/8-mechanical-properties-of-bone-and-cartilage/
https://www.britannica.com/science/bone-anatomy
https://courses.lumenlearning.com/physics/chapter/9-6-forces-and-torques-in-
muscles-and-joints/