Medical & Biological Engineering & Computing

https://doi.org/10.1007/s11517-020-02172-2

ORIGINAL ARTICLE

Age-related changes in mechanical properties of human

abdominal fascia
Miglena Kirilova-Doneva 1,2 & Dessislava Pashkouleva 2 & Stoyan Stoytchev 2

Received: 24 September 2019 / Accepted: 26 March 2020

# International Federation for Medical and Biological Engineering 2020

Abstract
The purpose of this study is to assess and model age-related changes in the mechanical properties of human fascia. The samples
were divided into three age groups: group A—up to 60 years (mean age 52.5 ± 6 years), group B—61–80 years (mean age 70.4 ±
5.2 years), and group C—81–90 years (mean age 83.2 ± 2 years). A uniaxial tensile test was applied to fascia specimens cut
perpendicular and parallel to fibers. The secant modulus at 5% strain, the maximum stress, and the stretch at maximum stress
were calculated from the stress-stretch ratio curves. The results indicated an increase in the secant modulus with the increased age.
The trend is clearer in the longitudinal direction. Considering the strain energy function which accounts the isotropic and non-
isotropic response of the fascia where isotropic and anisotropic parts are split, we evaluated which material model is the most
suitable to present isotropic mechanical behavior of the tissue. The experimental stress-stretch ratio curves were approximated
using Mooney-Rivlin, Yeoh, and neo-Hookean strain energy functions and a good match between theoretical and experimental
results was obtained. On the basis of objective function values and normalized mean square root error, we recommend using the
Yeoh model to describe the isotropic mechanical behavior of human abdominal fascia.

Keywords Human abdominal fascia . Mechanical properties . Strain energy function . Experimental data

1 Introduction
Numerous experimental studies have been conducted to char-
acterize in vivo and ex vivo mechanical response of the ab-
dominal wall or its layers. The latest results are those pub-
lished in [1–5]. In vivo examinations take into consideration
muscle activity and study local stiffness and deformation of
the wall [6, 7]. Ex vivo experiments are used to model the
passive mechanical behavior of the human abdomen under
physiological loads and also to predict the site of a hernia
formation where higher stresses can be identified [8, 9].
Overall, the geometry of the human abdomen is obtained by
magnetic resonance imaging but in order to describe the me-
chanical properties of different anatomical structures of the
abdomen, experimental results for these layers are necessary.
* Miglena Kirilova-Doneva
miglena_doneva@abv.bg
1
Faculty of Pharmacy, Medical University of Sofia, 2 Dunav Str.,
1000, Sofia, Bulgaria
2
Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G.
Bonchev Str., Bl. 4, Sofia, Bulgaria
There are nine layers of the abdominal wall: skin, subcu-
taneous tissue, superficial fascia, external oblique muscle,
internal oblique muscle, transversus abdominis muscle,
transversalis fascia, preperitoneal adipose and areolar tissue,
and peritoneum. According to Findley and Schleip, “Fascia
is the soft tissue component of the connective tissue system
that permeates the human body, forming a continuous three-
dimensional matrix of structural support. It surrounds all
o rg a n s , m u s c l e s , b o n e s a n d n e r v e f i b e r s ” [ 1 0 ] .
Experimental data about the main units which contribute to
the mechanical stability of the abdominal wall like linea alba
and rectus sheet have already been reported in the literature
[3, 8, 11]. As far as we know, there is a lack of experimental
data about other layers of the wall. In order to obtain a real-
istic simulation of the mechanical behavior of the abdominal
wall, all layers should be investigated and approximated with
suitable strain energy functions (SEF). As a step in this di-
rection, this paper aims to evaluate which material model is
the most suitable to present non-linear behavior of human
fascia. We also intend to describe the effects of age on the
mechanical properties of this type of tissue and quantify the
long-term changes in strength and elasticity of human ab-
dominal fascia (HAF).

The strength and the deformability of the fascia have
attracted the attention of many investigators over the last de-
cade. There are reported investigations about the mechanical
properties of thoracolumbal fascia in [11], lumbodorsal fascia
in [12], fascia lata in [13, 14], tibial fascia in [13], and nasal
fascia in [15]. There is no information about the long-term
changes in the mechanical properties of the human abdominal
fascia which was the main reason to initiate this research.
2 Materials and methods
2.1 Materials
For the purposes of this study, the results of tensile testing of
84 samples of human umbilical and inguinal abdominal fascia
from 13 donors were used. All available samples were har-
vested from non-herniated subjects. The samples were dissect-
ed free of fat and adhering material. The methodology of
selecting and investigating specimens was described in details
in the previous study [16]. Briefly, 10 × 70-mm specimens
were cut parallel (L direction) and perpendicular (T direction)
to the collagen fibers as shown in Fig. 1. A thickness Gauge
D-2000 (Hans Schmidt, Germany) was used to measure the
thickness of the samples h. The sample thickness h was mea-
sured at five points and the averaged value was used in the
protocol [16].
The average age of the patients was 66.3 years in the range of
45–87 years. The specimens were divided into three age groups:
up to 60 years (group A—14 samples cut in the L direction and
13 samples in the T direction, mean age 52.5 ± 6 years), 61–
80 years (group B—13 samples in the L direction and 9 samples
in the T direction, mean age 70.4 ± 5.2 years), and 81–90 years
(group C—22 samples in the L direction and 15 samples in the T
direction, mean age 83.2 ± 2 years). The specimens taken from
umbilical and inguinal fascia were combined because the
Fig. 1 View of human abdominal fascia
Med Biol Eng Comput
previous results had shown that there were no statistically signif-
icant differences in the mechanical properties of abdominal fascia
according to localization [16].
2.2 Experimental method
The experiments with HAF are published in [16]. Uniaxial
tension tests were performed using a universal testing machine
(FU 1000e, Germany) at a constant speed of 0.13 mm/s. The
initial clamp-to-clamp distance of samples was 30 mm. The
force was measured with a 500 N load cell with a minimal
resolution of 0.2 N. The grip surfaces were covered with
roughened rubber in order to prevent sliding of the strips.
The specimens were marked with Indian ink at the grips and
the experiment was accepted as successful only if the marks
did not move during the loading and the rupture occurred not
near to the grips. [16].
The specimens were preconditioned, that is, the loading
and unloading of the samples were done while experimen-
tally obtained load-elongation curves coincide. After anal-
ysis of the preliminary tests, 4% strain was chosen as an
appropriate non-damaging strain and was applied in the
preconditioning of the samples. This repeatable state was
reached during the third cycle of preconditioning. Thus,
the third cycle was continued until rupture of the sample.
The initial length of the specimens L0 was measured after
preconditioning at the moment when the axial force began
to differ from zero.
The Cauchy stress-stretch ratio curves were obtained using
the experimental force-displacement data. The Cauchy stress
was defined as σ = F/dS, where F is the force and dS is the
deformed cross section of the sample, normal to the acting
force. The ratio between the deformed length and the initial
length is the stretch λ = L/L0, where the L0 is the undeformed
length and L is the deformed length of the sample. The secant
modulus, defined as a ratio of stress to strain at 5% strain Е(5),
maximum or ultimate stress σmax, and stretch at maximum
stress λσmax were determined from the stress-stretch ratio
curves. The median stress-strain curve for every age group
was chosen in case of odd samples or calculated as the mean
curve of the closest two curves in case of even numbers of
curves as described in [17]. The median values for σmax, E(5),
λσmax, and their absolute median deviation of the three age
groups were calculated and compared. The differences be-
tween age groups were assessed using the Wilcoxon test and
Kruskal-Wallis test. A p value of less than 0.5 was considered
to be statistically significant for all comparisons.
2.3 Theoretical background
Mathematical modeling of mechanical properties of soft tissue
consists of three problems—to quantify the actual behavior of
the tissue using experiments, to represent this data by
Med Biol Eng Comput

mathematical model, and to find the parameter values in the Table 1 Values of the mechanical parameters ± AMD for HAF in the L
direction
model that best match the experiment.
As Fig. 1 evidences, the fascia tissue is a composite of two Group σmax (MPa) E(5) (MPa) λσmax h (mm)
sheets consisting of collagen fibers. The samples were cut
along the collagen fibers of the lower sheet (L direction) and A 2.94 ± 0.80 0.84 ± 1.40 1.2 ± 0.10 0.71 ± 0.16
perpendicular to them (T direction). The experimental stress- B 2.76 ± 0.73 14.96 ± 8.30 1.2 ± 0.04 1.61 ± 0.09
strain relations (Figs. 1 and 2, Tables 1 and 2) show that the C 2.37 ± 0.51 8.82 ± 5.40 1.2 ± 0.50 1.45 ± 0.16
mechanical behavior of fascia tissue is quite different in both
AMD, absolute median deviation
directions, namely the maximal stress in L direction is greater
than that in T direction while the maximal strain is lesser.
Therefore, the considered type of flat fascia tissue is assumed
to be a fiber-reinforced material with relatively stiff collage- ψ ¼ ψiso ðI 1 ; I 2 ; I 3 Þ þ ψani ðI 4 ; I 6 Þ; ð1Þ
nous fibers embedded in a homogeneous isotropic (soft)
ground matrix. The passive mechanical behavior of the con- where ψiso is the isotropic part, usually associated with
sidered type of material is characterized by a strain energy ground matrix, and ψani describes anisotropic properties,
function per unit reference volume in which isotropic and dissociated with collagen fibers [20]. As a particular
the anisotropic parts are split [8, 18–20]. choice for ψ, the study of Holzapfel and Weizsaker
[18] proposed a combined polynomial-exponential form.
They suggest to use the neo-Hookean model:
a
ψiso ¼ μðI 1 −3Þ ð2Þ

for the isotropic contribution, with the stress-like ma-

terial parameter μ > 0, and the first invariant I1. Usually
the isotropic response was modeled by means of the SEF
proposed by Demiray et al. [21], Moony-Rivlin and Yeoh,
whereas the anisotropic response was represented by the
phenomenological exponential SEF [19, 20].
In this study, we focused on this part of SEF which de-
scribed an isotropic response of the fascia. We intend to eval-
uate which material model—neo-Hookean, Moony-Rivlin, or
Yeoh—is the most suitable to present isotropic mechanical
behavior of the tissue.
The strain energy function (SEF) is defined as the en-
ergy stored in material per unit reference volume in the
b initial configuration. SEF is denoted as W, W = f(I1, I2, I3),
where I1, I2, and I3 are the three strain invariants of the
Green deformation tensor defined in terms of principal
stretch ratios λ1, λ2, and λ3 [22].

I 1 ¼ λ21 þ λ22 þ λ23 ð3Þ

Table 2 Values of the mechanical parameters ± AMD for HAF in the T

direction

Group σmax (MPa) E(5) (MPa) λσmax h (mm)

A 0.76 ± 0.14 1.26 ± 0.60 1.35 ± 0.05 0.90 ± 0.30

B 0.51 ± 0.23 2.04 ± 1.02 1.25 ± 0.05 1.31 ± 0.26
C 1.10 ± 0.07 3.40 ± 0.20 1.40 ± 0.10 1.32 ± 0.36
Fig. 2 The Cauchy stress-strain curves according to age: a L direction, b
T direction AMD, absolute median deviation
 Med Biol Eng Comput

I 2 ¼ λ21 λ22 þ λ21 λ23 þ λ22 λ23 ð4Þ Consequently, the stresses are:

S 1 ¼ S; S 2 ¼ S 3 ¼ 0 ð8Þ
I 3 ¼ λ21 ⋅λ22 ⋅λ23 ð5Þ
The first and second invariants I1 and I2 of the strain tensor
Shahzad et al. considered two types of material models— in this case are presented as:
phenomenological models and physically motivated models
2
[23]. The phenomenological models treat the problem from I 1 ¼ λ21 þ λ22 þ λ23 ¼ λ2 þ ð9Þ
λ
the viewpoint of continuum mechanics without reference to
the microscopic structure while physically motivated models
1
consider the microstructure of the material. Usually commer- I 2 ¼ λ21 λ22 þ λ21 λ23 þ λ22 λ23 ¼ 2λ þ ð10Þ
cially available finite element software packages, such as λ2
ABAQUS, include the following models for numerical simu-  
1
2  1 1
lation: neo-Hookean, Mooney-Rivlin, Yeoh, second-degree E1 ¼ λ −1 ; E2 ¼ −1 ð11Þ
reduced polynomial, second-degree polynomial, Ogden up 2 2 λ
to third degree, and Arruda-Boyce model.
Finally, Cauchy stress was calculated as:
Hoss and Marczak presented a comprehensive study for
the most applicable SEF for rubber-like materials, and an-
σ ¼ λ2 S ð12Þ
alyzed and compared the contribution of different SEF in
uniaxial, shear, and biaxial testing [24]. The goodness of fit The SEF proposed by neo-Hookean (Eq. 13), Mooney-
and prediction performance was estimated using a special Rivlin (Eq. 14), and Yeoh (Eq. 15) were used to calculate
grade system to rank the models. Following the conclu- theoretical Cauchy stress σ.
sions of Hoss and Marczak, we chose the models of
Mooney-Rivlin and Yeoh to characterize the elastic behav- W ¼ aðI 1 −3Þ ð13Þ
ior of fascia. Those models were also used in the literature
to fit the fascia results by Brandao and Bhattarai [25, 26].
The Mooney-Rivlin model is a two-parameter model W ¼ aðI 1 −3Þ þ bðI 2 −3Þ ð14Þ
that works well for moderately large strains in uniaxial
elongation and shear deformation but cannot describe
the S-curvature of the experimental force-extension curve W ¼ aðI 1 −3Þ þ bðI 1 −3Þ2 þ cðI 1 −3Þ3 ð15Þ
[24]. The Yeoh model has the form of a third-degree re-
duced polynomial based on the first strain invariant only. Applying Eqs. 7 to 13, we obtained the theoretical stress
It can fit the initial part of the stress-strain curve over a relations of neo-Hookean equation:
large strain range and can simulate various models of
deformation with limited data [27].  
1
Because of the assumption of incompressibility, (I3 = 1), σHook ¼a λ − 2
ð16Þ
λ
only two independent strain measures I1 and I2 remain and
W is a function of I1 and I2. Theoretical stress relations according to Mooney-Rivlin
The second Piola-Kirchhoff stresses Si can be determined equation:
as [22]:
   
∂W 1 ∂W 1 1
Si ¼ ¼ ; ð6Þ σMR ¼a λ − 2
þ b λ− 2 ð17Þ
∂E i λi ∂λi λ λ

where λi is the stretch ratio and Ei is the Green-Lagrange Theoretical stress relations according to Yeoh equation:



strain tensor E i ¼ 12 λ2i −1 .
Under the condition of incompressibility for uniaxial  
1
stretch, the deformations are: σY ¼ λ λ− 2
λ
"    2 #
2 2
1 1  a þ b λ þ −3 þ c λ þ −3
22
ð18Þ
λ1 ¼ λ; λ2 ¼ λ3 ¼ pffiffiffi ; λ22 ¼ λ23 ¼ ð7Þ λ λ
λ λ
Med Biol Eng Comput
In this work, we hypothesize that the isotropic behavior of
the abdominal fascia tissue is predominantly expressed in the
T direction experiments because the contribution of the colla-
gen fibers in this direction could be assessed as negligible.
Therefore, only the experimental stress-strain relations in the
T direction were used for parameter estimation of the assumed
models. Here it should be noted the well-known fact that the
problem of material parameter estimation has no unique solu-
tion in view of which the optimization procedure must be
described in details in order the obtained results to be com-
pared with others using the same procedure. We implemented
a three-step procedure in which at the first place the intervals
of material parameters variation were determined so that the
stresses remain positive on the basis of MatLab2013a utilities.
As a second step, optimization procedure by means of
Levenberg-Marquardt algorithm was applied with Med Calc
17.9.7 Software. The iteration process with different tolerance
of calculations up to six orders of accuracy and different num-
bers of iterations was accomplished. The fittings were per-
formed multiple times starting with randomized parameters
because of problems with global minima [28]. The last step
was to estimate the suitability of material parameters and
method for optimization of the experimental curve was ap-
plied [28]. For this, the values of objective function F(σexp,
σcal) which equals to sum of the residuals and normalized
mean square root error (MSRE) ɛ were calculated [3, 28].
h
 i
F ¼ ∑ σexp −σ cal 2
ð19Þ
i i
i groups A and C (p = 0.01) and for groups B and C (p = 0.01)
F is calculated for the T direction and σcal is notation for
calculated values of Cauchy stress. The normalized MSRE ɛ
is defined as:
rffiffiffiffiffiffiffiffi
F ences between the values of parameters σmax, E(5), and
n−q
ε¼ ; ð20Þ
μ in this direction differ significantly (p = 0.03).
where n is the number of points at which the stress is cal-
culated, q is the number of constants in the SEF, and μ is the
mean value of experimentally obtained stress μ ¼ 1n ∑σi . The
values of MSRE and ɛ were compared for the three considered
models and those with the minimal ɛ were considered to most
closely characterize experimental data.
3 Results
3.1 Estimates of the experimental mechanical
characteristics of HAF
The obtained median curves in both directions for age groups
A, B, and C are presented in Fig. 2 a and b. The shape of the
curves is concave with an almost linear initial part. The max-
imum stress and elastic moduli in the L direction for fascia are
higher than those in the T direction reflecting the structure of
the samples. The process of aging can be described based on
the elasticity of the material—in both directions, the elasticity
of fascia decreases.
The values of the main mechanical parameters for the
investigated samples—maximal Cauchy stress σ max ,
stretch at maximum stress λmax, and secant modulus Е(5)
of samples—are presented in Tables 1 and 2. The values
for λmax exceed 1.2 for all age groups and are in the 1.2–
1.5 range. Maximum stress σmax is greater than 2 MPa in
the L direction and 0.5 MPa in the T direction.
The secant modulus E(5) increases with age in both direc-
tions. Modulus Е(5) for group A is between 8 and 14 times
lower than Е (5) for groups B and C in the L direction
(0.84 MPa vs. 14.96 MPa or 8.21 MPa for the L direction).
Modulus Е(5) for group A in the T direction is more than three
times lower than Е(5) for groups B and C in the T direction
(1.26 MPa vs. 2.04 MPa or 3.40 MPa in the T direction).
The thickness of the samples was analyzed according to
age and the result was that the older adults displayed higher
fascial thickness. The thickness increases by 50 to 100% in
groups B and C (Tables 1 and 2) compared with group A.
The Kruskal-Wallis statistical analysis was performed to
evaluate the statistically significant differences between the
parameters of age groups. We found that there were statisti-
cally significant differences between the values of Е(5) for
in the L direction. There were statistically significant differ-
ences between the values of σmax for groups A and C (p =
0.02), and for thickness between groups A and B as well as A
and C in the same direction. In the T direction, the results are
totally different—there are no statistically significant differ-
λσmax according to the age. Only the values of fascia thickness
Finally, our experimental data convincingly show that the
human abdominal fascia is a highly orthotropic material with
ultimate stress in the L direction much higher than in the T
direction (2 MPa vs. 0.5 MPa). Next, the stress-strain relation
for younger adults is S-shaped which shows the predominant
role of elastic fibers in this group. The shape of the experi-
mental curves suggests that for people over 60 years, it is
possible to describe the mechanical properties of fascia using
linear moduli.
3.2 Estimation of the mechanical parameters
in the model equations
The experimental data for human abdominal fascia, shown
in Fig. 2b, were approximated using neo-Hookean,
Mooney-Rivlin, and Yeoh models. The curves were

approximated to the experimental value of maximum
(ultimate) stress. We applied the three-step procedure de-
scribed in Section 2.2 for choosing the best-fit constants.
The iteration process completes when the difference be-
tween the values of the model and experiments is of six
orders of magnitude.
In order to specify the most suitable model for our ex-
perimental data, the values of objective function F (which
minimize the difference between the experimental values
and the values obtained in Eqs. 16, 17, and 18 in the least
squares sense) and the normalized mean square root error
(MSRE) ɛ for the models were analyzed.
The values of the objective function F and normalized
mean square root error ɛ are presented in Fig. 3. F values
are in the interval (0.0002–0.17 MPa) where F values for
Mooney-Rivlin and Yeoh according to age group are very
close. The mean value of MSRE for Mooney-Rivlin is
a imental data; (2) The proposed SEF of neo-Hook and
b One of the problems which influence the outcome of abdom-
Fig. 3 Values of a the objective function F and b the normalized mean
square root error ɛ
Med Biol Eng Comput
Table 3 The values of the optimal coefficients for the model of Yeoh in
T direction
Group a (MPa) b (MPa) c (MPa)
A 0.36 ± 0.06 4.44 ± 0.73 − 11.02 ± 1.89
B 0.67 ± 0.02 3.03 ± 0.51 − 18.39 ± 2.45
C 1.50 ± 0.07 − 1.75 ± 0.69 0.04 ± 1.41
0.11 ± 0.04, the mean value of MSRE for Yeoh is 0.05 ±
0.06, and the mean value of MSRE for neo-Hookean is
0.36 ± 0.09. The difference between mean values of
MSRE mentioned above is not statistically significant
(p = 0.19) but suggests that probably the model of Yeoh
will be a suitable choice.
The results of the best-fitting procedure can be summa-
rized as follows: (1) The values of the standard error of
the regression ɛ in each age group are close for the three
SEF, and therefore, they approximate properly the exper-
Mooney-Rivlin failed in good approximation of the exper-
imental data for group A because of their S-shape; (3) The
model of Yeoh describes in the best way the mechanical
behavior of HAF in the transversal direction.
The values of the optimal coefficients for the models
considered (model of Yeoh) are presented in Table 3.
The experimental and the theoretical stress-strain rela-
tions for all models are shown in Fig. 4.
After visual evaluation of the results and according to pre-
vious conclusions, we stated that the model of Yeoh is the
most suitable one from the proposed three models.
4 Discussion
inal operations is the age-related variability of the mechanical
properties of abdominal layers. Their detailed description is a
necessary tool for a realistic simulation of the abdominal wall
which requires incorporation of the mechanical properties of
fascia in the mathematical model. To our knowledge, the stud-
ies in [16, 29–31] present experiments with abdominal fascia.
The study of Kureshi et al. reported material orthotropy,
weakness of the material in the transversal direction, and ex-
tension at maximal stress 50–60% [29]. Low flexibility and
extension at maximal stress 30–50% are also reported by [30].
The results of one-dimensional assays of fascia specimens
show that fascia exhibits significant strength but slightly rela-
tive elongation which is similar to those obtained for other
collagen-rich tissues such as tendons and skin [32].
The new data in this study is the description of the mechan-
ical properties of abdominal fascia according to age. It is
Med Biol Eng Comput

a known that during senescence, connective tissues become

stiffer, stronger, and less flexible. Decreased flexibility [33,
34] and increased fascial stiffness [35] have been reported in
older individuals. Our results support the tendency, namely
that the older fascia samples are stiffer than younger ones.
Indeed, the elastic modulus increases with the age. We show
significant age-dependent differences in modulus and ultimate
stress between the elastic modulus of group B vs. group C and
group A vs. group C in the longitudinal direction. The expect-
ed changes however are not clearly exhibited in the transversal
direction. A decrease in maximum stress σmax is evident for
group B while maximum stress for group C increases. During
senescence, the increase in the amount of collagen leads to a
decrease in maximum stretch and an increase in mechanical
stiffness [35]. Wilke et al. tested the hypothesis that older
adults display higher fascial thickness [36]. Our results also
confirmed the significant increase.
b A number of constitutive models of abdominal organs and
their soft tissues layers have been proposed in recent years.
Brandao et al. modeled pubovisceral fascia and pelvic floor
muscles using SEF of Yeoh [26]. Rivaux et al. modeled pelvic
fascia and ligaments using SEF of Ogden (N = 1) [37]. Gatton
et al. proposed a three-dimensional mathematical model of the
thoracolumbar fascia [38], and Bhattaray modeled the biome-
chanical properties of pelvic structures applying Mooney-
Rivlin SEF and Chaudhry estimated a superficial nasal fascia
using Demiray’s model [25, 39]. Searching the most suitable
constitutive equations based on our experimental results, we
applied three types of SEF which have been successfully used
by other authors.
Summarizing the results from this investigation, we can
state that all three models demonstrate reasonable predictions
at intermediate and large strain, but that the initial S-shaped
c part in group A is fitted good only from Yeoh model. Our
hypothesis was that only one function will fit the experimental
results perfectly but the unexpected result was that all models
used predicted results in a similar way; only the values of
MSRE for MR and Hook are higher than those for Yeoh. As
the quality of fitting is nearly equal, the question is which
model should be recommended?
The simplest and reasonable choice is to compare the sum
of the values of the objective functions for all age groups.
According to the applied model, these values are 0.014 ±
0.002 (FMR) vs. 0.021 ± 0.01 (FY) vs. 0.18 ± 0.1 (FH). After
comparison of the results and visual evaluation, the reasonable
choice is the model of Yeoh.

4.1 Limitations of the study

The measurement technique of the strain of the sample during

Fig. 4 The experimental (filled squares) and the theoretical stress-strain
relations for assumed models: a group A, b group B, c group C uniaxial test is based on the displacements between grips to
calculate the so-called global stretches which represent an
average measure of the strain ratios. Some authors used a

non-contact optical system in strain measurement of biologi-
cal materials [40]. The authors obtained that stretch ratio is
smaller near the grips compared with the value in the central
sample region, that is, the deformation field of the strip is non-
uniform, the largest stretches being in the middle of the strip
length. Having in mind that our samples (10 × 70 mm) are
comparatively long, the boundary effects near the grips could
be neglected and, therefore, the used approach is approxima-
tive [40].
The presented research evaluates only the isotropic part of
SEF. The obtained constants can be used only as initial values
in a finite element simulation and in a model of the abdominal
wall. The next step is to evaluate the influence of fibers in the
biomechanical analysis of fascia. If such model is developed,
it will predict the effect of age in real-life circumstances by
appropriately increasing material parameters describing stiff-
ness of the tissue.
5 Conclusions
The results obtained address the numerical simulation of the
structure of the abdominal wall. As a step in this direction, this
paper presents age-dependent variations in mechanical prop-
erties of human abdominal fascia. The influence of age on the
elastic properties of fascia is clearly demonstrated. The secant
modulus and thickness of HAF increase in the process of
aging. The results are more evident in the longitudinal
direction.
Non-linear equations of polynomial form suitable for direct
use with commercially available software packages were ap-
plied. The agreement between the proposed theoretical model
and the experiment was assessed using minimization of ob-
jective function and convergence tolerance of six orders of
magnitude. It was obtained that the numerical solution
matched the experimental solution very well. During the
fitting process, the models that better matched the experimen-
tal data were chosen. We recommend using the Yeoh SEF.
Compliance with ethical standards
Ethical approval All procedures performed in studies were in accor-
dance with the ethical standards of the institutional Ethics Committee at
Bulgarian Academy of Sciences (reference number N36/24.02.2016) and
with the 1964 Helsinki declaration and its later amendments or compara-
ble ethical standards.
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Publisher’s note Springer Nature remains neutral with regard to jurisdic-
tional claims in published maps and institutional affiliations.
Miglena Kirilova-Doneva has a PhD degree from 2008. She works at
Bulgarian Academy of Sciences and Medical University of Sofia. Her
fields of research are Biomechanics of soft tissues and Biomaterials.
Dessislava Pashkouleva has a PhD degree from 2004. She works at
Bulgarian Academy of Sciences, department of Solid Mechanics. Her
fields of research are Material Science & Technology, Biomechanics
and Rheology.
Stoyan Stoytchev graduated from Sanct Petersburg State University. He
has PhD degree from 1979 and works in the fields of Mechanics,
Biomechanics, Modeling of biological tissues and processes.