Biomechanics of pressure ulcer in body tissues interacting with external forces during locomotion

Annual Review of Biomedical Engineering

Volumn 12, Issue , 2010, Pages 29-53

  Mak, Arthur F T ^a   Zhang, Ming ^a   Tam, Eric W C ^a  

^a HONG KONG POLYTECHNIC UNIVERSITY   (Hong Kong)

Author keywords

deep tissue injury; ischemic reperfusion; pressure ulcer; rehabilitation engineering; skin; tissue biomechanics

Indexed keywords

PRESSURE ULCER; REHABILITATION ENGINEERING; REPERFUSION; TISSUE BIOMECHANICS; TISSUE INJURY;

ARTIFICIAL LIMBS; BIOMECHANICS; BIOPHYSICS; GRAVITATION; HISTOLOGY; MICROCIRCULATION; TISSUE ENGINEERING;

TISSUE;

BIOMECHANICS; BUTTOCK; DECUBITUS; DERMIS; EPIDERMIS; FORCE; HUMAN; IN VITRO STUDY; IN VIVO STUDY; LIMB; LOCOMOTION; MICROCIRCULATION; NONHUMAN; PROSTHESIS; REPERFUSION INJURY; REVIEW; SHEAR STRESS; SKIN BLOOD FLOW; SKIN ULCER; SUBCUTANEOUS TISSUE; TISSUE INJURY; TISSUE PERFUSION; ANIMAL; COMPUTER SIMULATION; FEMALE; MECHANICAL STRESS; MOUSE; PATHOLOGY; PATHOPHYSIOLOGY; PHYSIOLOGY; PRESSURE ULCER; PROSTHESES AND ORTHOSES; RAT;

ANIMALS; BIOMECHANICS; COMPUTER SIMULATION; FEMALE; HUMANS; LOCOMOTION; MICE; PRESSURE ULCER; PROSTHESES AND IMPLANTS; RATS; REPERFUSION INJURY; STRESS, MECHANICAL; BIOMECHANICAL PHENOMENA;

EID: 77955612422     PISSN: 15239829     EISSN: None     Source Type: Book Series    
DOI: 10.1146/annurev-bioeng-070909-105223     Document Type: Review

References (169)

1. Daniel RK, Priest DL, Wheatley DC. 1981. Etiology factors in pressure ulcers: an experimental model. Arch. Phys. Med. Rehabil. 62:492-498
2. Byrne DW, Salzberg CA. 1996. Major risk factors for pressure ulcers in the spinal cord disabled: a literature review. Spinal Cord 34:255-263
3. Sumiya T, Kawamura K, Tokuhiro A, Takechi H, Ogata H. 1997. A survey of wheelchair use by paraplegic individuals in Japan. Part 2: Prevalence of pressure ulcers. Spinal Cord 35:595-598 (Pubitemid 27401740)
4. Brand PW. 1979. Management of the insensitive limb. Phys. Ther. 59:8-12
5. Boulton AJM, Betts RP, Franks CI. 1987. Abnormalities of foot pressure in early diabetic neuropathy. Diabet. Med. 4:225-228
6. Pecoraro RE, Reiber GE, Burges EEM. 1990. Pathways to diabetic limb amputation: basis for prevention. Diabetes Care 13:513-521
7. Levy SW. 1980. Skin problems of the leg amputee. Prosthet. Orthot. Int. 4:37-44
8. Nielsen CC. 1991. A survey of amputees: functional level and life satisfaction, information needs, and the prosthetist's role. J. Prosthet. Orthot. 3:125-129
9. Lyon CC, Kulkarni J, Zimerson E, Van Ross E, Beck MH. 2000. Skin disorders in amputees. J. Am. Acad. Dermatol. 42:501-507
10. Reddy M, Gill SS, Kalkar SR, Wu W, Anderson PJ, Rochon PA. 2008. Treatment of pressure ulcers: a systematic review. J. Am. Med. Assoc. 300:2647-2662
11. Kanitakis J. 2002. Anatomy, histology and immunohistochemistry of normal human skin. Eur. J. Der-matol. 12:390-401
12. Brown IA. 1973. A scanning electron microscope study of the effects of uniaxial tension on human skin. Br. J. Dermatol. 89:383-393
13. Yanir Y. 1987. Skin mechanics. In Handbook of Bioengineering, ed. R Skalak, C Shu, pp. 11.1-11.25. New York: McGraw-Hill
14. Pasyk KA, Thomas SV, Hassett CA, Cherry GW, Faller R. 1989. Regional differencesin capillary density of the normal human dermis. Plast. Reconstr. Surg. 83:939-947
15. Lumpkin EA, Caterina MJ. 2007. Mechanisms of sensory transduction in the skin. Nature 445:858-865
16. Kirk JE, Chieffi M. 1962. Variation with age in elasticity of skin and subcutaneous tissue in human individuals. J. Gerontol. 17:373-380
17. Hall DA, Blackett AD, Zajac AR, Switala S, Airey CM. 1981. Changes in skinfold thickness with increasing age. Age Ageing 10:19-23
18. Ziegert JC, Lewis JL. 1978. In vivo mechanical properties of soft tissues covering bony prominences. ASME J. Biomech. Eng. 100:194-201
19. Barbenel JC, Payne PA. 1981. In vivo mechanical testing of dermal properties. In Bioengineering and the Skin, ed. R Marks, PA Payne, pp. 8-38. Lancaster, UK: MTP
20. Dikstein S, Hartzshtark A. 1981. In vivo measurement of some elastic properties of human skin. In Bioengineering and the Skin, ed. R Marks, PA Payne, pp. 45-53. Lancaster, UK: MTP
21. Bader DL, Bowker P. 1983. Mechanical characteristics of skin and underlying tissues in vivo. Biomaterials 4:305-308
22. Malinauskas M, Krouskop TA, Barry PA. 1989. Noninvasive measurement of the stiffness of tissue in the above-knee amputation limb. J. Rehabil. Res. Dev. 26:45-52
23. LanirY, Dikstein S, Hartzshtark A, Manny V. 1990.In vivo indentation of human skin. ASME J. Biomech. Eng. 112:63-69
24. Mak AFT, Liu GHW, Lee SY. 1994. Biomechanical assessment of below-knee residual limb tissue. J. Rehabil. Res. Dev. 31:188-198
25. Vannah WM, Childress DS. 1996. Indentor tests and finite element modeling of bulk muscular tissue in vivo. J. Rehabil. Res. Dev. 33:239-252
26. Zheng YP, Mak AFT. 1996. An ultrasound indentation system for biomechanical properties assessment of soft tissues in vivo. IEEE Trans. Biomed. Eng. 43:912-918
27. Pathak AP, Silver-Thorn B, Thierfelder CA, Prieto TE. 1998. A rate-controlled indentor for in vivo analysis of residual limb tissues. IEEE Trans. Rehabil. Eng. 6:12-20
28. Zheng YP, Mak AFT. 1999. Effective elastic properties for lower limb soft tissues from manual indentation experiment. IEEE Trans. Rehabil. Eng. 7:257-267
29. Zheng YP, Mak AFT. 1999. Extraction of quasi-linear viscoelastic parameters for lower limb soft tissues from manual indentation experiment. ASME J. Biomech. Eng. 121:330-339
30. Zheng YP, Choi YKC, Wong K, Chan S, Mak AFT. 2000. Biomechanical assessment of plantar foot tissue in diabetic patients using an ultrasound indentation system. Ultrasound Med. Biol. 26:451-456
31. Zheng YP, Mak AFT, Zhang M, Leung AKL. 2001. State-of-the-art methods for residual limb assessment: a review. J. Rehabil. Res. Dev. 38:487-504
32. Gefen A, Megido-Ravid M, Itzchak Y. 2001. In vivo biomechanical behavior of human heel pad during the stance phase of gait. J. Biomech. 34:1661-1665
33. Erdemir A, Viveiros ML, Ulbrecht JS, Cavanagh PR. 2006. An inverse finite-element model of heel pad indentation. J. Biomech. 39:1279-1286
34. Then C, Menger J, Benderoth G, Alizadeh M, Vogl TJ, et al. 2007. A method for a mechanical characterization of human gluteal tissue. Technol. Health Care 15:385-398
35. Makhsous M, Venkatasubramanian G, Chawla A, Pathak Y, Priebe M, et al. 2008. Investigation of soft-tissue stiffness alteration in denervated human tissue using an ultrasound indentation system. J. Spinal Cord Med. 31:88-96
36. Burbridge BE. 2007. Computed tomographic measurement of gluteal subcutaneous fat thickness in reference to failure of gluteal intramuscular injections. Can. Assoc. Radiol. J. 58:72-75
37. Linder-Ganz E, Shabshin N, Itzchak Y, Yizhar Z, Siev-Ner I, Gefen A. 2008. Strains and stresses in subdermal tissue of the buttocks are greater in paraplegics than in healthy during sitting. J. Biomech. 41:567-580
38. Todd BA, Thacker JG. 1994. Three-dimensional computer model of the human buttocks, in vivo. J Rehabil. Res. Dev. 31:111-119
39. Gefen A,Gefen N, Linder-Ganz E,Marqulies SS. 2005. In vivo muscle stiffening under bone compression promotes deep tissue sores. ASME J. Biomech. Eng. 127:512-524
40. Lemmon D, Shiang AH, Ulbrecht JS, Cavanagh PR. 1997. The effect of insoles intherapeutic footwear\a finite element approach. J. Biomech. 30:615-620
41. Miller-Young JE, Duncan NA, Baroud G. 2002. Material properties of the human calcaneal fat pad in compression experiment and theory. J. Biomech. 35:1523-1531
42. Gooding GAW, Stess RM, Graf PM. 1986. Sonography of the sole of the foot. Evidence for loss of foot pad thickness in diabetes and its relationship to ulceration of the foot. Invest. Radiol. 21:45-48
43. Childress DS, Steege JW. 1987. Computer-aided analysis of below-knee socket pressure. J Rehabil. Res. Dev. 2:22-24
44. Reynolds DP, Lord M. 1992. Interface load analysis for computer-aided design of below-knee prosthetic sockets. Med. Biol. Eng. Comput. 30:419-426
45. Zheng YP, Mak AFT, Lue BK. 1999. Objective assessment of limb tissue elasticity: development of a manual indentation procedure. J. Rehabil. Res. Dev. 36:71-85
46. Tonuk E, Silver-Thorn MB. 2003. Nonlinear elastic material properties estimation of lower extremity residual limb tissues. IEEE Trans. Neural Syst. Rehabil. Eng. 11:43-53
47. Allen V, Ryan DW, Lomax N, Murray A. 1993. Accuracy of interface pressure measurement systems. J. Biomed. Eng. 15:344-348
48. Ferguson-Pell MW, Cardi MD. 1993. Prototype development and comparative evaluation of wheelchair pressure mapping system. Assist. Technol. 5:78-91
49. Buis A, Convery P. 1997. Calibration problems encountered while monitoring stump/socket interface pressures with force sensing resistors: techniques adopted to minimize inaccuracies. Prosthet. Orthot. Int. 21:179-182
50. Pipkin L, Sprigle S. 2008. Effect of model design, cushion construction, and interface pressure mats on interface pressure and immersion. J. Rehabil. Res. Dev. 45:875-882
51. Goossens RH, Snijders CJ, Holscher TG, Heerens WC, Holman AE. 1997. Shear stress measured on beds and wheelchairs. Scand. J. Rehabil. Med. 29:131-136
52. Sprigle S, Dunlop W, Press L. 2003. Reliability of bench tests of interface pressure. Assist. Technol. 15:49-57
53. Bogie K, Wand X, Fei B, Sun J. 2008. New technique for real-time interface pressure analysis: getting more out of large image data sets. J. Rehabil. Res. Dev. 45(4):523-536
54. Dabnichki P, Taktak D. 1998. Pressure variation under the ischial tuberosity during a push cycle. Med. Eng. Phys. 20:242-256
55. Kernozek TW, Lewin JE. 1998. Seat interface pressure of individuals with paraplegia: influence of dynamic wheelchair locomotion compared with static seated measurements. Arch. Phys. Med. Rehabil. 79:313-316
56. Tam EW, Mak AF, Lam WN, Evans JH, Chow YY. 2003. Pelvic movement and interface pressure distribution during manual wheelchair propulsion. Arch. Phys. Med. Rehabil. 84:1466-1472
57. Lord M. 1981. Foot pressure measurement: a review of methodology. J. Biomed. Eng. 3:91-99
58. Cavanagh PR, Hewitt FG, Perry JE. 1992. In-shoe plantar pressure measurement:areview. Foot 2:185-194
59. Urry S. 1999. Plantar pressure-measurement sensors. Meas. Sci. Technol. 10:R16-32
60. Morag E, Cavanagh PR. 1999. Structural and functional predictors of regional peak pressures under the foot during walking. J. Biomech. 32:359-370
61. Lott DJ, Zou D, Mueller MJ. 2008. Pressure gradient and subsurface shear stress on the neuropathic forefoot. Clin. Biomech. 23:342-348
62. Lord M, Hosein R. 1994. Pressure redistribution by molded inserts in diabetic footwear: a pilot study. J. Rehabil. Res. Dev. 31:214-221
63. Kato H, Takada T, Kawamura T, Hotta N, Torii S. 1996. The reduction and redistribution of plantar pressure using foot orthoses in diabetic patients. Diabetes Res. Clin. Pract. 31:115-118
64. Tsung BYS, Zhang M, Mak AFT, Wong MWN. 2004. Effectiveness of insoles on plantar pressure redistribution. J. Rehabil. Res. Dev. 41:767-774
65. Tsung YS, Zhang M, Fan YB, Boone DA. 2003. Quantitative comparison of plantar foot shapes under different weight-bearing conditions. J. Rehabil. Res. Dev. 40:517-526
66. McPoil TG, Cornwall MW. 1992. Effect of insole materials on force and plantar pressures during walking. J. Am. Podiatr. Med. Assoc. 82:412-416
67. Mandato MG, Nester E. 1999. The effects of increasing heel height on forefoot peak pressure. J. Am. Podiatr. Med. Assoc. 89:75-80
68. Praet SF, Louwerens JW. 2003. The influence of shoe design on plantar pressures in neuropathic feet. Diabetes Care 26:441-445
69. Tappin JW, Robertson KP. 1991. Study of the relative timing of shear forces on the sole of the forefoot during walking. J. Biomed. Eng. 13:39-42
70. Lord M, Hosein R. 2000. A study of in-shoe plantar shear in patients with diabetic neuropathy. Clin. Biomech. 15:278-283
71. Cong Y, Luximon Y, Zhang M. 2009. Plantar pressure and shear stress in high-heeled shoes. Proc. WACBE World Congrr Bioeng., Hong Kong, p. 232
72. Yavuz M, Tajaddini A, Botek G, Davis BL. 2008. Temporal characteristics of plantar shear distribution: relevance to diabetic patients. J. Biomech. 41:556-559
73. Mak AFT, Zhang M, Boone DA. 2001. State-of-the-art research in lower-limb prosthetic biomechanics-socket interface: a review. J. Rehabil. Res. Dev. 38:161-174
74. Williams RB, Porter D, Roberts VC. 1992. Triaxial force transducer for investigating stresses at the stump/socket interface. Med. Biol. Eng. Comput. 1:89-96
75. Sanders JE, Daly CH. 1993. Measurement of stresses in three orthogonal directions at the residual limb-prosthetic socket interface. IEEE Trans. Rehabil. Eng. 1(2):79-85
76. Lee VSP, Solomonidis SE, Spence WD. 1997. Stump-socket interface pressure as an aid to socket design in prostheses for trans-femoral amputees\a preliminary study. J. Eng. Med. 211:167-180
77. Zhang M, Turner-Smith AR, Tanner A, Roberts VC. 1998. Clinical investigation of the pressure and shear stress on the trans-tibial stump with a prosthesis. Med. Eng. Phys. 20:188-198
78. Goh JCH, Lee PVS, Chong SY. 2003. Stump/socket pressure profiles of the pressure cast prosthetic socket. Clin. Biomech. 18:237-243
79. Polliack AA, Sieh RC, Craig DD, Landsberger S, McNeil DR, Ayyappa E. 2000. Scientific validation of two commercial pressure sensor systems for prosthetic socket fit. Prosthet. Orthot. Int. 24:63-73
80. Meier RH, Meeks ED, Herman RM. 1973. Stump-socket fit of below-knee prostheses: comparison of three methods of measurement. Arch. Phys. Med. Rehabil. 54:553-558
81. Sanders JE, Zachariah SG, Jacobsen AK, Ferguson JR. 2005. Changes in interface pressures and shear stresses over time on trans-tibial amputee subjects ambulating with prosthetic limbs: comparison of diurnal and six-month differences. J. Biomech. 38:1566-1573
82. Dou P, Jia XH, Suo SF, Wang RC, Zhang M. 2006. Pressure distribution at the stump/socket interface in transtibial amputees during walking on stairs, slope and non-flat road. Clin. Biomech. 21:1067-1073
83. Appoldt FA, Bennett L, Contini R. 1970. Tangential pressure measurements in above-knee suction sockets. Bull. Prosthet. Res. Spring:70-86
84. Jia XH, Suo SF, Meng F, Wang RC. 2008. Effects of alignment on interface pressure for transtibial amputee during walking. Disabil. Rehabil. Assist. Technol. 3:339-343
85. Sanders JE, Zachariah SG, Baker AB, Greve JM, Clinton C. 2000. Effects of changes in cadence, prosthetic componentry, and time on interface pressures and shear stresses of three trans-tibial amputees. Clin. Biomech. 15:684-694
86. Groth KE. 1942. Clinical observations and experimental studies on the origin of decubitus ulcers. Acta Chir. Scand. 87(Suppl. 76):1-209
87. Kosiak M. 1961. Etiology of decubitus ulcers. Arch. Phys. Med. Rehabil. 42:19-29
88. Reswick JB, Rogers J. 1976. Experience at Rancho Los Amigos Hospital with devices and techniques to prevent pressure ulcers. In Bed Ulcer Biomechanics, ed. RM Kenedi, JM Cowden, JT Scales, pp. 301-310 London: Macmillan
89. Reddy NP, Cochran GVB, Krouskop TA. 1981. Interstitial fluid flow as a factor in decubitus ulcer formation. J. Biomech. 14:879-881
90. Sacks AH. 1989. Theoretical prediction of a time-at-pressure curve for avoiding pressure ulcers. J. Rehabil. Res. Dev. 26:27-34
91. Bader D, Bouten C, Colin D, Oomens C, eds. 2005. Pressure Ulcer Research: Current and Future Perspectives. Berlin: Springer. 382
92. Murno D. 1940. Care of the back following spinal-cord injuries: a consideration of bed ulcers. N. Engl. J. Med. 223:391-398
93. Barnett RI, Ablarde JA. 1994. Skin vascular reaction to standard patient positioning on a hospital mattress. Adv. Skin Wound Care 7:58-65
94. Wang WZ, Anderson G, Firrell JC, Tsai TM. 1998. Ischemic preconditioning versus intermittent reperfusion to improve blood flow to a vascular isolated skeletal muscle flap of rats. J. Trauma 45:953-959 (Pubitemid 28524998)
95. Sundin BM, Hussein MA, Glasofer S, El-Falaky MH, Abdel-Aleem SM, et al. 2000. The role of allop-urinol and deferoxamine in preventing pressure ulcers in pigs. Plast. Reconstr. Surg. 105:1408-1421
96. Baldwin KM. 2001. Transcutaneous oximetry and skin surface temperature as objective measures of pressure ulcer risk. Adv. Skin Wound Care 14:26-31
97. WAF-1, bax protein, and apoptosis. Ann. Plast. Surg. 48:68-74
98. Krouskop TA. 1983. A synthesis of the factors that contribute to pressure sore formation. Med. Hypotheses 11:255-267
99. Miller GE, Seake JL. 1987. The recovery of terminal lymph flow following occlusion. J. Biomed. Eng. 109:48-54
100. Reddy NP. 1990. Effects of mechanical stresses on lymph and interstitial fluid flow. In Pressure Ulcers: Clinical Practice and Scientific Approach, ed. DL Bader, pp. 203-222 London: Macmillan
101. Bulkley GB. 1987. Free radical-mediated reperfusion injury: a selected review. Br. J. Cancer. 55(Suppl. VIII):66-73
102. Granger DN. 1988. Role of xanthine oxidase and granulocytes in ischemia-reperfusion injury. Am. J. Physiol. 255:H1269-75
103. Herrman EC, Knapp CF, Donofrio JC, Salcido R. 1999. Skin perfusion responses to surface pressure-induced ischemia: implication for the developing pressure ulcer. J. Rehabil. Res. Dev. 36:109-120
104. Clavien PA, Yadav S, Sindram D, Bentley RC. 2000. Protective effects of ischemic preconditioning for liver resection performed under inflow occlusion in humans. Ann. Surg. 232:155-162
105. Collard CD, Gelman S. 2001. Pathophysiology, clinical manifestations, and prevention of ischemia-reperfusion injury. Anesthesiology 94:1133-1138
106. Tayor R, James T. 2005. The role of oxidative stress in the development and persistence of pressure ulcers. See Reference 91, pp. 205-232
107. McCord JM. 2000. The evolution of free radicals and oxidative stress. Am. J. Med. 108:652-659
108. Reichel SM. 1958. Shearing force as a factor in decubitus ulcers in paraplegics. J. Am. Med. Assoc. 166:762-763
109. Dinsdale SM. 1974. Decubitus ulcers: role of pressure and friction in causation. Arch. Phys. Med. Rehabil. 55:147-152
110. Bennett L. 1972. Transferring loading to flesh. Part III: Analysis of shear stress. Bull. Prosthet. Res. 10:38-51
111. Bennett L, Kavner D, Lee BK, Trainor FA. 1979. Shear vs. pressure as causative factors in skin blood flow occlusion. Arch. Phys. Med. Rehabil. 60:309-314
112. Rowland J. 1993. Pressure ulcers: a literature review and a treatment scheme. Aust. Fam. Physician 22:1822-1827
113. Bennett L, Lee BY. 1988. Vertical shear existence in animal pressure threshold experiments. Decubitus 1:18-24
114. Zhang M, Roberts VC. 1993. The effect of shear forces externally applied to skin surface on underlying tissues. J. Biomed. Eng. 15:451-456
115. Quintavalle PR, Lyder CH, Mertz PJ, Phillips-Jones C, Dyson M. 2006. Use of high-resolution, high-frequency diagnostic ultrasound to investigate the pathogenesis of pressure ulcer development. Adv. Skin Wound Care 19:498-505
116. Stekelenburg A, Strijkers GJ, Parusel H, Bader DL, Nicolay K, Oomens CW. 2007. Role of ischemia and deformation in the onset of compression-induced deep tissue injury: MRI-based studies in a rat model. J. Appl. Physiol. 102:2002-2011
117. Ceelen KK, Stekelenburg A, Loerakker S, Strijkers GJ, Bader DL, et al. 2008. Compression-induced damage and internal tissue strains are related. J. Biomech. 41:3399-3404
118. Ceelen KK, Stekelenburg A, Mulders JLJ, Strijkers GJ, Baaijens FPT, et al. 2008. Validation of a numerical model of skeletal muscle compression with MR tagging: a contribution to pressure ulcer research. ASME J. Biomech. Eng. 130(6):061015
119. Linder-Ganz E, Shabshin N, Itzchak Y, Gefen A. 2007. Assessment of mechanical conditions in sub-dermal tissues during sitting: a combined experimental-MRI and finite element approach. J. Biomech. 40:1443-1454
120. Linder-Ganz E, Shabshin N, Itzchak Y, Yizhar Z, Siev-Ner I, Gefen A. 2008. Strains and stresses in subdermal tissues of the buttocks are greater in paraplegics than in healthy during sitting. J. Biomech. 41:567-580
121. Linder-Ganz E, Yarnitzky G, Yizhar Z, Siev-Ner I, Gefen A. 2009. Real-time finite element monitoring of sub-dermal tissue stresses in individuals with spinal cord injury: toward prevention of pressure ulcers. Ann. Biomed. Eng. 37:387-400
122. Portnoy S, Yizhar Z, Shabshin N, Itzchak Y, Kristal A, et al. 2008. Internal mechanical conditions in the soft tissues of a residual limb of a trans-tibial amputee. J. Biomech. 41:1897-1909
123. Yarnitzky G, Yizhar Z, Gefen A. 2006. Real-time subject-specific monitoring of internal deformations and stresses in the soft tissues of the foot: a new approach in gait analysis. J. Biomech. 39:2673-2689
124. Grujicic M, Pandurangan B, Arakere G, Bell WC, He T, Xie X. 2009. Seat-cushion and soft-tissue material modeling and a finite element investigation of the seating comfort for passenger-vehicle occupants. Mater. Des. 30:4273-4285
125. Cheung JTM, Zhang M. 2008. Parametric design of pressure-relieving foot orthosis using statistics-based finite element method. Med. Eng. Phys. 30:269-277
126. Zhang M, Mak AFT, Roberts VC. 1998. Finite element modeling of a residual lower-limb in a prosthetic socket: a survey of the development in the first decade. Med. Eng. Phys. 20:360-373
127. Lee WCC, Zhang M, Jia XH, Cheung JTM. 2004. Finite element modeling of the contact interface between trans-tibial residual limb and prosthetic socket. Med. Eng. Phys. 26:655-662
128. Jia XH, Zhang M, Lee WCC. 2004. Load transfer mechanics between trans-tibial prosthetic socket and residual limb\dynamic effects. J. Biomech. 37:1371-1377
129. Zhang M, Lord M, Turner-Smith AR, Roberts VC. 1995. Development of a nonlinear finite element modeling of the below-knee prosthetic socket interface. Med. Eng. Phys. 17:559-566
130. Zhang M, Turner-Smith AR, Roberts VC, Tanner A. 1996. Frictional action at lower limb/prosthetic socket interface. Med. Eng. Phys. 18:207-214
131. Zhang M, Mak AFT. 1996. A finite element analysis of the load transfer between an above-knee residual limb and its prosthetic socket\the roles of interface friction and the distal-end boundary conditions. IEEE Trans Rehabil. Eng. 4:337-346
132. Zachariah SG, Sanders JE. 2000. Finite element estimates of interface stress in the trans-tibial prosthesis using gap elements are different from those using automated contact. J. Biomech. 33:895-899
133. Cheung JTM, Zhang M, Leung AKL, Fan YB. 2005. Three-dimensional finite element analysis of the foot during standing\a material sensitivity study. J. Biomech. 38:1045-1054
134. Yu J, Cheung JTM, Fan YB, Zhang Y, Leung AKL, Zhang M. 2008. Development of a finite element model of female foot for high-heeled shoe design. Clin. Biomech. 23:S31-38
135. Mak AFT, Huang LD, Wang QQ. 1994. A biphasic poroelastic analysis of the flow dependent subcutaneous tissue pressure and compaction due to epidermal loadings: issues in pressure sore. ASME J. Biomech. Eng. 116:421-429
136. Zhang JD, Mak AFT, Huang LD. 1997. A large deformation biomechanical model for pressure ulcers. ASME J. Biomech. Eng. 119:406-408
137. Houwing T, Overgoor M, Kon M, Janen G, Van Asbeeck BS, Haalboom JRE. 2000. Pressure-induced skin lesions in pigs: reperfusion injury and the effects of vitamin E. J. Wound Care 9:36-40
138. Peirces SM, Skalak TC, Rodeheaver GT. 2000. Ischemia-reperfusion injury in chronic pressure ulcer formation: a skin model in the rat. Wound Repair Regen. 8:68-76
139. Tsuji S, Ichioka S, Sekiya N, Nakatsuka T. 2005. Analysis of ischemia-reperfusion injury in a microcir-culatory model of pressure ulcers. Wound Repair Regen. 13:209-215
140. Bader DL. 1990. The recovery characteristics of soft tissues following repeated loading. J. Rehabil. Res. Dev. 27:141-150
141. Mak AFT, Tam EWC, Tsung BYS, Zhang M, Zheng YP, Zhang JD. 2003. Biomechanics of body support surfaces: issues of decubitus ulcer. In Frontiers in Biomedical Engineering, ed. NHC Hwang, SLY Woo, pp. 111-134 New York: Kluwer/Plenum
142. Schubert V, Schubert PA, Breit G, Intaglietta M. 1995. Analysis of arterial flow motion in spinal-cord injured and elderly subjects in an area at risk for the development of pressure sores. Paraplegia 33:387-397
143. Li ZY, Tam EWC, Leung JYS, Mak AFT. 2006. Wavelet analysis of skin blood oscillations in persons with spinal cord injury and able-bodied subjects. Arch. Phys. Med. Rehabil. 87:1207-1212
144. Bollinger A, Hoffman U, Franzeck UK. 1991. Evaluation of flow motion in man by laser Doppler technique. Blood Vessels 28(Suppl. 1):21-26
145. Bracic M, Stefanovska A. 1998. Wavelet-based analysis of human blood-flow dynamics. Bull. Math. Biol. 60:919-935
146. Kvernmo HD, Stefanovska A, Kirkeboen KA. 2003. Enhanced endothelial activity reflected in cutaneous blood flow oscillations of athletes. Eur. J. Appl. Physiol. 90:16-22
147. Bertuglia S, Colantuoni A, Arnold M, Witte H. 1996. Dynamic coherence analysis of vasomotion and flow motion in skeletal muscle microcirculation. Microvasc. Res. 52:235-244
148. Stefanovska A, Bracic M, Kvernmo HD. 1999. Wavelet analysis of oscillations in the peripheral blood circulation measured by laser Doppler technique. IEEE Trans. Biomed. Eng. 46:1230-1239
149. Soderstrom T, Stefanovska A, Veber M, Svensson H. 2003 Involvement of sympathetic nerve activity in skin blood flow oscillations in humans. Am. J. Physiol. Heart Circ. Physiol. 284:H1638-46
150. Bergstrand S, Lindberg LG, Ek AC, Linden M, Lindgren M. 2009. Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques. Skin Res. Technol. 15:139-147
151. Sanders JE, Goldstein BS. 2001. Collagen fibril diameters increase and fibril densities decrease in skin subjected to repetitive compressive and shear stresses. J. Biomech. 34:1581-1587
152. Sanders JE, Mitchell SB, Wang YN, Wu K. 2002. An explant model for the investigation of skin adaptation to mechanical stress. IEEE Trans. Biomed. Eng. 49:1626-1631
153. Saito Y, Hasegawa M, Fujimoto M, Matsushita T, Horikawa M, et al. 2008. The loss of MCP-1 attenuates cutaneous ischemia-reperfusion injury in a mouse model of pressure ulcer. J. Invest. Dermatol. 128: 1838-1851
154. Blaisdell FW. 2002. The pathophysiology of skeletal muscle ischemia and the reperfusion syndrome: a review. Cardiovasc. Surg. 10:620-630
155. Unal S, Ozmen S, Demir Y, Yavuzer R, Latifoglu O, Atabay K. 2001. The effect of gradually increased blood flow on ischemia-reperfusion injury. Ann. Plast. Surg. 47:412-416
156. Nola GT, Vistnes LM. 1980. Differential response of skin and muscle in the experimental production of pressure sores. Plast. Reconstr. Surg. 66:728-733
157. Stekelenburg A, Oomens CWJ, Strijkers GJ, Nicolay K, Bader DL. 2006. Compression-induced deep tissue injury examined with magnetic resonance imaging and histology. J. Appl. Physiol. 100:1946-1954
158. Kwan MPC, Tam EWC, Lo SCL, Leung MCP, Lau RYC. 2007. The time effect of pressure on tissue viability: investigation using an experimental rat model. Exp. Biol. Med. 232:481-487
159. Linder-Ganz E, Gefen A. 2004. Mechanical compression-induced pressure sores in a rat hindlimb: muscle stiffness, histology, and computational models. J. Appl. Physiol. 96:2034-2049
160. Linder-Ganz E, Engelberg S, Scheinowitz M, Gefen A. 2006. Pressure-time cell death threshold for albino rat skeletal muscles as related to pressure sore biomechanics. J. Biomech. 39:2725-2732
161. Peeters EAG, Oomens CWJ, Bouten CVC, Bader DL, Baaijens FPT. 2005. Mechanical and failure properties of single attached cells under compression. J. Biomech. 38:1685-1693
162. Bouten CVC, Knight MM, Lee DA, Bader DL. 2001. Compressive deformation and damage of muscle cell subpopulations in a model system. Ann. Biomed. Eng. 29:153-163
163. Breuls RGM, Bouten CVC, Oomens CWJ, Bader DL, Baaijens FPT. 2003. Compression induced cell damage in engineered muscle tissue: an in vitro model to study pressure ulcer etiology. Ann. Biomed. Eng. 31:1357-1364
164. Gawlitta D, Li W, Oomens CWJ, Baaijens FPT, Bader DL, Bouten CVC. 2006. The relative contributions of compression and hypoxia to development of muscle tissue damage: an in vitro study. Ann. Biomed. Eng. 35:273-284
165. Gefen A, van Nierop B, Bader DL, Oomens CWJ. 2008. Strain-time cell-death threshold for skeletal muscle in a tissue-engineered model system for deep tissue injury. J. Biomech. 41:2003-2012
166. Ceelen KK, Oomens CWJ, Stekelenburg A, Bader DL, Baaijens FPT. 2009. Changes in intracellular calcium during compression of C2C12 myotubes. Exp. Mech. 49:25-33
167. Siu PM, Tam EW, Teng BT, Pei XM, Ng JW, et al. 2009. Muscle apoptosis is induced in pressure-induced deep tissue injury. J. Appl. Physiol. 107:1266-1275
168. Linder-Ganz E, Gefen A. 2009. Stress analysis coupled with damage laws to determine biomechanical risk factors for deep tissue injury during sitting. ASME J. Biomech. Eng. 131(1):01 1003
169. Ceelen KK, Oomens CWJ, Baaijens FPT. 2008. Microstructural analysis of deformation-induced hy-poxic damage in skeletal muscle. Biomech. Model. Mechanobiol. 7:277-284