Soft tissues in the pelvic region - novel characterization of properties and modifiers, and their influence on musculoskeletal loading

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During fall-related impacts, the risk of tissue damage is directly related to the magnitude and distribution of impact loads. While the field generally recognizes the important influence of soft tissues on impact dynamics during falls on the lateral pelvis (i.e. `hip' region), there is limited information about the characteristics of these tissues, the factors that modify them, and algorithms that accurately describe their influence on impact dynamics. Accordingly, the proposed research, comprised of four complementary `Themes', will generate novel insights into the basic mechanical properties of the soft tissues in the pelvic region, their underlying modifiers, and how these soft tissues influence loading dynamics. Themes 1 and 2 will use novel ultrasound imaging techniques to investigate how individual factors (e.g. sex, age, body composition) influence the thickness and mechanical properties of pelvic soft tissues. This will be accomplished through a comprehensive application of shear wave elastography, and B-mode imaging synchronized with indentation force-deflection profiling. In Theme 3, human volunteers will be used to examine the influence of these soft tissue properties on lateral pelvis impact dynamics. Specifically, participants will undergo a series of loading scenarios (static lying to low energy falls). Impact kinetics applied to the pelvic skin surface will be measured with force plates and high-speed pressure measurement systems, and we will examine how the soft tissue properties examined in Themes 1 and 2 relate to impact dynamics. All previous outcomes will be integrated in Theme 4 through the use a validated mechanical hip impact simulator. Surrogate soft tissue materials, custom-made to match the range of properties observed in Themes 1-3, will be used to create up to 100 surrogate soft tissue coverings. These soft tissues, incorporated into the hip impact simulator, will undergo simulated sideways falls with a range of impact energies. Load sensing systems will measure impact kinetics, including the loads ultimately transmitted to the underlying femur. In summary, the proposed program of research will produce the world's most robust characterization of soft tissue properties in the pelvic region, in addition to the influence of these tissues on the loads applied to the hip region during lateral impacts. In addition to improving mathematical and mechanical models of lateral impact, this research will catalyze collaborations with industry partners to improve the design of engineering-based load attenuation devices for pressure sores and hip fractures. The trainees involved will experience an equitable, diverse, and inclusive research environment that uses multi-disciplinary approaches including experimental studies with humans, novel imaging technology, mechanical impact simulators, and mathematical modeling. These novel skill-sets will support their emergence as future leaders in academic or industry settings.