An MR-Compatible Device for Imaging the Lower Extremity During Movement and Under Load Team Leader: Eric Bader Communicator: Arinne Lyman BSAC: Christopher Westphal BWIG: Sarajane Stevens Client: Professor Darryl Thelen Advisor: Professor William Murphy

Overview Problem Statement Problem Statement Motivation Motivation Background Background –Muscle Anatomy/Injury –Gait Cycle Design Constraints Design Constraints Previous Prototype Previous Prototype Preliminary Testing Preliminary Testing Redesign Redesign –Manufacturing –Improvements –Materials and Costs Future Work Future Work References References images/photos/machine.jpg

Problem Statement Most current muscle imaging techniques are static. New dynamic imaging techniques can provide direct measurements of biomechanical function. However, measuring dynamic motion requires the use of a non- magnetic device for loading or guiding the limb through a desired, repeatable movement. Our initial intended application is to use Cine-PC (Phase Contrast) imaging to measure in-vivo musculotendon motion of the hamstrings muscles during a stretch-shortening cycle. Cine-PC requires multiple cycles of motion, necessitating that the device guide the limb through a repeatable motion at relatively low loads.

Motivation Measure velocity of muscle fibers around scar tissue Measure velocity of muscle fibers around scar tissue Prevent re-injury Prevent re-injury Tailor rehabilitation programs Tailor rehabilitation programs Client stock image

Muscle Anatomy/Injury 3 separate muscles 3 separate muscles Pulled hamstring Pulled hamstring -Eccentric contraction Scar tissue formation Scar tissue formation Affects muscle performance Affects muscle performance Re-injury is common Re-injury is common cla.edu/hamstring.jpg

Gait Cycle Interested in swing phase Interested in swing phase Eccentric contraction of hamstring at late swing phase Eccentric contraction of hamstring at late swing phase Muscle must change leg direction Muscle must change leg direction Adapted from

Design Constraints Provide repeatable, harmonic motion Provide repeatable, harmonic motion Same start/end points – bore size Same start/end points – bore size Compatible with trigger device Compatible with trigger device Generate physiological load on hamstring Generate physiological load on hamstring Simulate swing phase of running Simulate swing phase of running Support thigh – limit movement Support thigh – limit movement Non-metallic, non-ferrous materials Non-metallic, non-ferrous materials

Previous Prototype

Achieved desired inertial loads Achieved desired inertial loads Bulky Bulky Slack in chain Slack in chain Difficulty adjusting inertia disks Difficulty adjusting inertia disks Poor material Poor material

Preliminary Testing Validated inertial loading system Validated inertial loading system Muscle active at end of lengthening Muscle active at end of lengthening

Re-design

Close Up

Manufacturing Mill Mill Lathe Lathe Band and Table Saws Band and Table Saws

Improvements More compact More compact Flexion of hip Flexion of hip Closed loop design Closed loop design Accommodates both legs Accommodates both legs Changing disks is Changing disks issimpler Reduces lateral motion Reduces lateral motion Increase gear ratio Increase gear ratio

Materials and Costs

Future Work Design cycle triggering device Design cycle triggering device Validation in motion capture lab Validation in motion capture lab Test in MRI – dynamic imaging Test in MRI – dynamic imaging Submit technote to journal Submit technote to journal

References 1. Asakawa DS, Nayak KS, Blemker SS, Delp SL, Pauly JM, Nishimura DG, Gold GE. Real-time imaging of skeletal muscle velocity. Journal of Magnetic Resonance Imaging. 2003; 18: Asakawa DS, Pappas GP, Blemker SS, Dracce JE, Delp SL. Cine phase-contrast magnetic resonance imaging as a tool for quantification of skeletal muscle motion. Seminars in Musculoskeletal Radiology. 2003; 7(4): Asakawa DS, Blemker SS, Gold BE, Delp SL. In vivo motion of the rectus femoris muscle after tendon transfer surery. Journal of Biomechanics. 2002; 35(8): Asakawa DS, Pappas GP, Blemker SS, Drace JE, Delp SL. Cine phase-contrast magnetic resonance imaging as a tool for quantification of skeletal muscle motion. Seminars in Musculoskeletal Radiology. 2003; 7(4): Barance PJ, Williams GN, Novotny JE, Buchanan TS. A method for measurement of joint kinematics of 3-D geometric models with cine phase contrast magnetic resonance imaging data. Journal of Biomechanical engineering. 2005; 127: Barrancce P, Williams G, Sheehan FT, Buchanan TS. Measurement of tibiofemoral joint motion using CINE-Phase Contrast MRI. 7. Barrancce P, Williams G, Sheehan FT, Buchanan TS. Measurement of tibiofemoral joint motion using CINE-Phase Contrast MRI. 8. Fellows RA, Hill NA, MacIntyre NJ, Harrison MM, Ellis RE, Wilson DR. Repeatability of a novel technique for in vivo measurement of three- dimensional patellar tracking using magnetic resonance imaging. Journal of Magnetic Resonance Imaging. 2005; 22: Komi PV. Stretch-shortening cycle: a powerful model to study normal and fatigued muscle. Journal of Biomechanics. 2000; 33: Neu CP, Hull ML. Toward an MRI-based method to measure non-uniform cartilate deformation: an MRI-cyclic loading apparatus system and steady-state cyclic displacement of articular cartilage under compressive loading. Journal of Biomechanical Engineering. 2003; 125(2): Pappas GP, Asakawa DS, Delp SL, Zajac FE, Drace JE. Nonuniform shortening in the biceps brachii during elbow flexion. Journal of Applied Physiology. 2002; 92: Patel VV, Hall K, Ries M, Lotz J, Ozhinsky E, Lindsey C, Lu Y, Majumdar S. A three-dimensional MRI analysis of knee kinematics. Journal of Orthopedic Research. 2004; 22: Patel VV, Hall K, Ries M, Lindsey C, Ozhinsky E, Lu Y, Majumdar S. Magnetic resonance imaging of patellofemoral kinematics with weight- bearing. Journal of Bone and Joint Surgery. 2003; 85: Patel VV, Hall K, Ries M, Lindsey C, Ozhinsky E, Lu Y, Majumdar S. Magnetic resonance imaging of patellofemoral kinematics with weight- bearing. Journal of Bone and Joint Surgery. 2003; 85: Rebmann AJ, Rausch T, Shibanuma N, Sheehan FT. The precision of CINE-PC and Fast-PC sequences in measuring skeletal kinematics. Proc. Intl. Soc. Mag. Reson. Med. 2001; 9: Rebmann AJ, Sheehan FT. Precise 3D skeletal kinematics using fast phase contrast magnetic resonance imaging. Journal of Magnetic Resonance Imaging. 2003; 17: Sheehan FT, Drace JE. Quantitative MR measures if three-dimensional patellar kinematics as a research and diagnostic tool. Medicine and Science in Sports and Exercise. 1999; 31(10): 1339-??. 18. Sheehan F, Zejac FE, Drace J. Imaging musculoskeletal function using dynamic MRI. Rehabilitation R&D Center Progress Report Thelen DG, Chumanov ES, Sherry MA, Heiderscheit BC. Neuromusculoskeletal models provice insights intot he mechanisms and rehabilitation of hamstring strains. Exercise and Sports Science Reviews. 2006; 34(3): Vedi V, Williams A, Tennant SJ, Spouse E, Hunt DM, Gedroyc WMW. Meniscal movement: an in vivo study using dynamic MRI. British Editorial Society of Bone and Joint Surgery. 1999; 81-B(1):37-41.

Questions?