Research
Accident & Emergency (A&E)
Active research collaboration with the A&E Department at Ninewells Hospital, Dundee, is currently focussed on reducing the risk of serious injury of victims in road traffic accidents (RTA) by simulating an accident within the facilities at IMAR and in reducing instances of injury caused when using domestic trampolines.
In RTA, one of the most important jobs of the paramedics is to immobilise victims and extricate them from vehicles with minimum movement to the head and neck, otherwise serious injury leading to paralysis may occur. Movement of simulated victims from a car is tracked by special high-tech 3D infra-red cameras evaluating various techniques for quick and safe extrication.
A recent increase in injured children using domestic trampolines has led to a joint collaborative initiative between IMAR and A&E to develop a computer based biomechanical model to investigate the causes of injury. The resulting simulation demonstrated that when two masses bounce out of phase on a trampoline, a transfer of kinetic energy from the larger mass (parent) to the lower mass (child) is likely to occur. This transfer of energy is associated with forces large enough to break bones.
Animation
Recent approaches from our colleagues at Duncan of Jordanstone College of Art have intrigued us to say the least. Our collaboration is focussed on exploring new avenues for potential research in the animation of materials, choreography and dancing in order to create a new domain of scientific enquiry in Motion Analytics.
Bone Growth in Young Footballers
The excellent facilities and expertise at both IMAR and the Centre for Anatomy and Human Identification (CAHID) have joined forces to unveil the mystery surrounding the effect of sustained training in young football players on the bone growth plates.
In addition, Rangers Football Club and their Youth Academy at Murray Park are major collaborators in allowing us access to their young and adult players for biomechanical assessment and foot pressure analysis. The scientific literature is weak in this area, particularly on young footballers, and we are currently on year three of this continuous study assessing the young players as they progress and develop through their careers. This longitudinal study is unique and is hoped to yield key scientific information and at the same time provide baseline biomechanical information for the players. This research could not have been possible without the collaboration and support from Rangers Football Club, the University of Dundee Institute of Sports and Exercise and the NHS Medical Physics Department.
Ashley Stephen (joint PhD student between CAHID, IMAR and ISE) was awarded the best student poster at the Society of the Study of Human Biology symposium held at Corpus Christi College, Cambridge. Ashley is looking at the effect of targeted sports activity on the growth plate. This was a prestigious meeting as it celebrated the career of Jim Tanner who was the UK's leading auxologist. “The Use of 3D MRI Technologyin the Evaluation of the Growth Plates of the Knee and Ankle”. Society for the Study of Human Biology - The Human Biology of Jim Tanner, 13th - 15th December 2011, Cambridge, UK. A Stephen, R J Abboud, B Ewing, B Oliver, S Black. This paper won the Best Poster Award.
Car Seating & Posture
Driving is something we do on a daily basis and we presume that manufacturers know best when it comes to the ergonomic design of the automobile’s cockpit, pedals, steering wheel, seat belt, seating, posture etc…until one day we suffer from pain in one or more joint of our body causing us to wonder about the cause. How many of you suffer from knee pain or discomfort when driving for a medium distance? Have you ever thought why? Research into car seating and comfort began at IMAR when a patient presented with an abnormal callous formation at the lateral side of the heels, which after thorough investigation and assessment was found to be related to a change in automobile use. A change from a normal car to a 4x4 SUV lead to a change in seating posture which affected the lower limb position resulting in callous formation. Research into this area and other related car safety measures are prominent on our list of on-going projects in collaboration with industry.
Work presented at:
6th International Conference on Innovative Seating, 7th - 8th February 2011, Frankfurt, Germany.“Automobile Seating and Foot Posture: the Missing Link”.
Cerebral Palsy
The motion analysis team and community paediatric physiotherapy team work very closely with children who have movement disorders such as cerebral palsy and spina bifida. There is no doubt that these collaborations have vastly improved the long-term management of these children who have conditions that change their functional ability as they grow. It is still not possible to accurately predict the long-term outcomes for these children but improved management throughout their growth has beneficial effects for the rest of their lives. Over 350 patients have been seen, assessed and helped in providing vital information in their clinical management. The data obtained is also used for extensive research in order to further explore hidden information to enhance our evolving knowledge.
Clubfoot
A further area of major interest is clubfoot, which has been one of the focuses of Professor Abboud’s research team since 1996. Extensive research and clinical work have recently introduced a new scoring system, the IMAR-Scoring System, as well as a novel IMAR-Clubfoot pictorial scale. Both combine for the first time clinical and biomechanical measurements that aim to objectively predict relapse to facilitate early intervention and assist surgeons in the evaluation of clinical and surgical outcomes
Examples of published articles:
http://www.thefootjournal.com/article/S0958-2592(09)00035-2/abstract
http://www.thefootjournal.com/article/S0958-2592(08)00008-4/abstract
http://www.orthopaedicsandtraumajournal.co.uk/article/S1877-1327(10)00032-1/abstract
http://www.bjj.boneandjoint.org.uk/content/83-B/7/1041.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/20307468
Correction of Scoliosis
The department and Dr Drew have collaborated with orthopaedic surgeons, Alistair Gibson and John Burke, from Edinburgh University and Edinburgh Royal Infirmary to develop an animal model of scoliosis that will enable novel orthopaedic implants to be evaluated. This collaboration has resulted in grant funding by the Medical Research Council. Currently we are using the model to evaluate a prototype spinal implant and associated surgical instrumentation that we have developed in collaboration with our Edinburgh colleagues.
Computing
Since 2001 we have conducted research in collaboration with Professor Stephen McKenna and Professor Ian Ricketts from the School of Computing which has focused in developing the acquisition and intelligent interpretation of data from radiographic images. Studies were developed to assess osteoporosis in patients with fractures and to expand the uses of image processing into other areas of clinical diagnosis such as monitoring of hip replacements, assessment and quantification of knee osteoarthritis and evaluation of shoulder reconstruction after shoulder replacements.
Examples of published articles:
http://www.jshoulderelbow.org/article/S1058-2746(11)00162-5/abstract
http://www.jshoulderelbow.org/article/S1058-2746(12)00076-6/abstract
http://www.medicalimagingandgraphics.com/article/S0895-6111(07)00172-3/abstract
Diabetic Foot
An area of research that is a particular focus for IMAR is the diabetic foot. Almost two decades ago, we found that diabetic patients suffered from muscle dysfunction. The tibialis anterior muscle, which decelerates the foot following heel strike during normal walking, showed an abnormal firing pattern in diabetic patients resulting in a forefoot ‘slap’. This increased the pressure under the forefoot and the duration of that contact which facilitate the development of foot ulcers that may ultimately result in amputation when combined with proprioceptive deficiency and/or ill-fitting footwear.
Examples of published articles:
http://www.sciencedirect.com/science/article/pii/S0268003399000388
The extensive facilities at IMAR to assess gait, foot pressure analysis and biomechanics have led to a close research working relationship with the Podiatry Unit at Queen Margaret University in evaluating blood flow and diabetic feet in collaboration with the Vascular Unit Dr Faisel Khan and the Diabetic Centre Professor Graham Leese at Ninewells Hospital and Medical School.
Examples of published articles:
http://www.thefootjournal.com/article/S0958-2592(02)00115-3/abstract
http://www.thefootjournal.com/article/S0958-2592(03)00063-4/abstract
Footwear
IMAR is engaged in a series of projects concerning footwear and biomechanics, which could ultimately help shoe manufacturers, design footwear to better protect the foot and ankle from related injury.
An example of the wide reaching aspects of the work of IMAR can be seen from a large study of commonly available footwear. One such study evaluated the support offered by different brands of running shoe. This study originally began 12 years ago. The proposal was to take a sample of running shoes from three brands/ price categories (inexpensive, medium and expensive) to see which was best. It is likely that most people would assume that the more expensive the running shoe the better its design and structure, and also that they would offer the runner a superior level of comfort and support.
We compared comfort, pressure attenuation and shock absorption within each of the categories and the results showed that the inexpensive and medium priced shoes were just as good, if not better in some instances, then the most expensive. In other words, paying more for your sports shoes does not guarantee a better shoe. The first phase of this study, published in the British Journal of Sports Medicine formed a small part of a larger project which evaluated many aspects of running shoes, and in fact, we have now studied over 100 pairs of running shoes of different designs.
Examples of published articles:
http://bjsm.bmj.com/content/42/3/189
Forensic Medicine
This was a joint project with SPSA to provide information on the blood splatter profiles when an assailant kicks or jumps on a victim. A custom-made instrument was manufactured at the police forensic laboratories to provide a repeatable kicking force. To verify the correct operation of the ‘kicking’ instrument IMAR designed a stand to allow a force platform to be mounted vertically. Tests were then carried out in IMAR’s laboratory to verify the repeatability of the kick force and provide calibration information. A standard positioned force plate was also used to verify and provide calibration information on a second ‘stamping instrument’. The final trials performed using pig tissue and horse blood were performed at the SPSA forensic laboratories in Dundee.
Work presented at:
Scottish Police Authority Services and Scottish Institute for Policing Research Conference, 14th - 15th September 2010, Dundee, UK. “A study of blood patterns from kicking and stamping reconstructions and its application to case assessment and interpretation”. A Whigham, E Tucker, B Mallinder, K Robertson, G Jackson, R J Abboud, G Arnold, J Fraser.
Ice-skate Design
We have developed an ice skate which reduces the risk of injury during training for elite figure skaters. The design, which incorporates a novel mechanism to reduce ankle and knee joint loading, is currently under evaluation with professional skating coaches and elite level figure skaters. Based upon the success of this initial prototype we have designed a second more sophisticated device which is currently under patent application.
Minimal Access Surgery
In collaboration with the Institute of Medical and Surgical Technology (IMSaT), cutting edge research was developed and is being performed to ergonomically evaluate various newly designed laparoscopic equipment and devices to alleviate stress and fatigue for surgeons during minimal access surgery. This is carried out by simulation and custom built 3D motion models using the high-tech facilities at IMAR.
Plastic Surgery
Patients suffering from lower limb lymphedema suffer from excessive swelling of one or both legs from as little as 2 litres to as much as 9 litres or more per leg. This in no doubt affects their gait and would in turn affect their major lower joints and ultimately the spine. This may have adverse effect on health services and patient welfare over time. Pioneering surgery, developed in Europe, was adapted in Dundee by one of our leading plastic surgeons, Mr Alex Munnoch, and in collaboration with Professor Abboud a model was developed to evaluate and monitor the outcome the liposuction surgery. A signature has been found using gait and foot pressure analysis, which is currently being optimised for dissemination.
Proprioception
Proprioception is another element of biomechanics that we strongly believe needs to be fully examined and explored. We have been investigating proprioception since 1996 and it has been our firm belief that footwear is the main cause of most types of ankle injuries, if not the trigger. Recent studies have confirmed this by showing a direct link using custom-made one-axis rotating platforms and most recently three-axis rotating platforms part of a completed PhD project which complimented and confirmed the original findings.
Examples of published articles:
http://onlinelibrary.wiley.com/doi/10.1002/jor.20744/abstract
http://www.footanklesurgery-journal.com/article/S1268-7731(10)00103-7/abstract
http://www.thefootjournal.com/article/S0958-2592(10)00081-7/abstract
Spasticity Management in Adults
There are many adult conditions such as stroke, Parkinson’s disease and multiple sclerosis that affect functional ability and performance. These conditions can strike at any age therefore patients may have to live with them for many years. Motion analysis can improve the quality of life of such patients. Sometimes the interventions suggested from an analysis are very small (e.g. fine tuning an orthosis) but the impact and benefits to the individual can be huge. Some of our studies, in collaboration with Honorary Professor Sam El Jamal, involved the assessment of gait of those patients with subthalmic electrodes implantation to assess and optimise their shuffling gait.
Vitamin K and Ageing
A study of the effects of low vitamin K levels on the stiffness of arteries, which in turn may cause high blood pressure and vascular disease, especially in the elderly population is currently underway with The Department for Ageing and Health. The study is examining the effect of oral vitamin K supplementation in patients aged 70 and over with hypertension, type 2 diabetes or suffering from a previous vascular event. This is work is conducted in collaboration Professor Marion McMurdo and Dr Miles Witham.
Wheelchair, Seating, Orthotic and Prosthetic Design
Dundee is one of the very few cities in the UK to have its wheelchair, seating, orthotic and prosthetic services delivered in-house at the Tayside Rehabilitation Technology Services at Ninewells Hospital and Medical School. The association of these services with our university facilities has allowed for a close working relationship in teaching, research and clinical services using the latest high-tech biomechanical facilities at IMAR. Many projects are run on a yearly basis to optimise delivery as well as cost-effectiveness of products.
Examples of published articles:
http://www.sciencedirect.com/science/article/pii/S0268089002902689
http://bjsm.bmj.com/content/42/9/750.abstract
http://www.sciencedirect.com/science/article/pii/S0966636208000751
