TY - JOUR A1 - Hackl, Michael A1 - Nacov, Julia A1 - Kammerlohr, Sandra A1 - Staat, Manfred A1 - Buess, Eduard A1 - Leschinger, Tim A1 - Müller, Lars P. A1 - Wegmann, Kilian T1 - Intratendinous Strain Variations of the Supraspinatus Tendon Depending on Repair Technique: A Biomechanical Analysis Regarding the Cause of Medial Cuff Failure JF - The American Journal of Sports Medicine Y1 - 2021 U6 - https://doi.org/10.1177/03635465211006138 SN - 1552-3365 SN - 0363-5465 VL - 49 IS - 7 SP - 1847 EP - 1853 PB - Sage CY - London ER - TY - JOUR A1 - Horbach, Andreas A1 - Duong, Minh Tuan A1 - Staat, Manfred T1 - Modelling of compressible and orthotropic surgical mesh implants based on optical deformation measurement JF - Journal of the mechanical behavior of biomedical materials Y1 - 2017 U6 - https://doi.org/10.1016/j.jmbbm.2017.06.012 SN - 1751-6161 VL - 74 SP - 400 EP - 410 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Michael, Hackl A1 - Mayer, Katharina A1 - Weber, Mareike A1 - Staat, Manfred A1 - van Riet, Roger A1 - Burkhart, Klau Josef A1 - Müller, Lars Peter A1 - Wegmann, Kilian T1 - Plate osteosynthesis of proximal ulna fractures : a biomechanical micromotion analysis JF - The journal of hand surgery Y1 - 2017 U6 - https://doi.org/10.1016/j.jhsa.2017.05.014 SN - 0363-5023 VL - 42 IS - 10 SP - 834.e1 EP - 834.e7 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Bhattarai, Aroj A1 - Jabbari, Medisa A1 - Anding, Ralf A1 - Staat, Manfred T1 - Surgical treatment of vaginal vault prolapse using different prosthetic mesh implants: a finite element analysis JF - tm - Technisches Messen N2 - Particularly multiparous elderly women may suffer from vaginal vault prolapse after hysterectomy due to weak support from lax apical ligaments. A decreased amount of estrogen and progesterone in older age is assumed to remodel the collagen thereby reducing tissue stiffness. Sacrocolpopexy is either performed as open or laparoscopic surgery using prosthetic mesh implants to substitute lax ligaments. Y-shaped mesh models (DynaMesh, Gynemesh, and Ultrapro) are implanted in a 3D female pelvic floor finite element model in the extraperitoneal space from the vaginal cuff to the first sacral (S1) bone below promontory. Numerical simulations are conducted during Valsalva maneuver with weakened tissues modeled by reduced tissue stiffness. Tissues are modeled as incompressible, isotropic hyperelastic materials whereas the meshes are modeled either as orthotropic linear elastic or as isotropic hyperlastic materials. The positions of the vaginal cuff and the bladder base are calculated from the pubococcygeal line for female pelvic floor at rest, for prolapse and after repair using the three meshes. Due to mesh mechanics and mesh pore deformation along the loaded direction, the DynaMesh with regular rectangular mesh pores is found to provide better mechanical support to the organs than the Gynemesh and the Ultrapro with irregular hexagonal mesh pores. Insbesondere ältere, mehrgebährende Frauen leiden häufiger an einem Scheidenvorfall nach einer Hysterektomie aufgrund der schwachen Unterstützung durch laxe apikale Bänder. Es wird angenommen, dass eine verringerte Menge an Östrogen und Progesteron im höheren Alter das Kollagen umformt, wodurch die Gewebesteifigkeit reduziert wird. Die Sakrokolpopexie ist eine offene oder laparoskopische Operation, die mit prothetischen Netzimplantaten durchgeführt wird, um laxe Bänder zu ersetzen. Y-förmige Netzmodelle (DynaMesh, Gynemesh und Ultrapro) werden in einem 3D-Modell des weiblichen Beckenbodens im extraperitonealen Raum vom Vaginalstumpf bis zum Promontorium implantiert. Numerische Simulationen werden während des Valsalva-Manövers mit geschwächtem Gewebe durchgeführt, das durch eine reduzierte Gewebesteifigkeit modelliert wird. Die Gewebe werden als inkompressible, isotrop hyperelastische Materialien modelliert, während die Netze entweder als orthotrope linear elastische oder als isotrope hyperlastische Materialien modelliert werden. Die Positionen des Vaginalstumpfs, der Blase und der Harnröhrenachse werden anhand der Pubococcygeallinie aus der Ruhelage, für den Prolaps und nach der Reparatur unter Verwendung der drei Netze berechnet. Aufgrund der Netzmechanik und der Netzporenverformung bietet das DynaMesh mit regelmäßigen rechteckigen Netzporen eine bessere mechanische Unterstützung und eine Neupositionierung des Scheidengewölbes, der Blase und der Urethraachse als Gynemesh und Ultrapro mit unregelmäßigen hexagonalen Netzporen. Y1 - 2018 U6 - https://doi.org/10.1515/teme-2017-0115 SN - 2196-7113 VL - 85 IS - 5 SP - 331 EP - 342 PB - De Gruyter CY - Berlin ER - TY - JOUR A1 - Birgel, Stefan A1 - Leschinger, Tim A1 - Wegmann, Kilian A1 - Staat, Manfred T1 - Calculation of muscle forces and joint reaction loads in the shoulder area via an OpenSim based computer model JF - tm - Technisches Messen N2 - Using the OpenSim software and verified anatomical data, a computer model for the calculation of biomechanical parameters is developed and used to determine the effect of a reattachment of the Supraspinatus muscle with a medial displacement of the muscle attachment point, which may be necessary for a rupture of the supraspinatus tendon. The results include the influence of the operation on basic biomechanical parameters such as the lever arm, as well as the calculated the muscle activations for the supraspinatus and deltoid. In addition, the influence on joint stability is examined by an analysis of the joint reaction force. The study provides a detailed description of the used model, as well as medical findings to a reattachment of the supraspinatus. Mit der Software OpenSim und überprüften anatomischen Daten wird ein Computermodell zur Berechnung von biomechanischen Parametern entwickelt und genutzt, um den Effekt einer Refixierung des Supraspinatusmuskels mit einer medialen Verschiebung des Muskelansatzpunktes zu ermitteln, wie sie unter anderem nach einem Riss der Supraspinatussehne notwendig sein kann. Die Ergebnisse umfassen hierbei den Einfluss der Operation auf grundlegende biomechanische Parameter wie den Hebelarm sowie die berechneten Muskelaktivierungen für den Supraspinatus und Deltoideus. Zusätzlich wird der Einfluss auf die Gelenkstabilität betrachtet und durch eine Analyse der Gelenkreaktionskraft untersucht. Die Studie bietet eine detaillierte Beschreibung des genutzten Modells, sowie medizinische Erkenntnisse zu einer Refixierung des Supraspinatus. Y1 - 2018 U6 - https://doi.org/10.1515/teme-2017-0114 SN - 2196-7113 VL - 85 IS - 5 SP - 321 EP - 330 PB - De Gruyter CY - Berlin ER - TY - JOUR A1 - Bhattarai, Aroj A1 - Staat, Manfred T1 - Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions JF - Computational and Mathematical Methods in Medicine N2 - After menopause, decreased levels of estrogen and progesterone remodel the collagen of the soft tissues thereby reducing their stiffness. Stress urinary incontinence is associated with involuntary urine leakage due to pathological movement of the pelvic organs resulting from lax suspension system, fasciae, and ligaments. This study compares the changes in the orientation and position of the female pelvic organs due to weakened fasciae, ligaments, and their combined laxity. A mixture theory weighted by respective volume fraction of elastin-collagen fibre compound (5%), adipose tissue (85%), and smooth muscle (5%) is adopted to characterize the mechanical behaviour of the fascia. The load carrying response (other than the functional response to the pelvic organs) of each fascia component, pelvic organs, muscles, and ligaments are assumed to be isotropic, hyperelastic, and incompressible. Finite element simulations are conducted during Valsalva manoeuvre with weakened tissues modelled by reduced tissue stiffness. A significant dislocation of the urethrovesical junction is observed due to weakness of the fascia (13.89 mm) compared to the ligaments (5.47 mm). The dynamics of the pelvic floor observed in this study during Valsalva manoeuvre is associated with urethral-bladder hypermobility, greater levator plate angulation, and positive Q-tip test which are observed in incontinent females. Y1 - 2018 U6 - https://doi.org/10.1155/2018/9518076 SN - 1748-6718 VL - 2018 IS - Article ID 9518076 SP - 1 EP - 16 PB - Hindawi CY - New York, NY ER - TY - JOUR A1 - Jung, Alexander A1 - Staat, Manfred T1 - Modeling and simulation of human induced pluripotent stem cell-derived cardiac tissue JF - GAMM - Mitteilungen der Gesellschaft für Angewandte Mathematik und Mechanik Y1 - 2019 U6 - https://doi.org/10.1002/gamm.201900002 SN - 1522-2608 VL - 42 IS - 4 PB - Wiley CY - Weinheim ER - TY - JOUR A1 - Linder, Peter A1 - Beckler, Matthias A1 - Doerr, Leo A1 - Stoelzle-Feix, Sonja A1 - Fertig, Niels A1 - Jung, Alexander A1 - Staat, Manfred A1 - Gossmann, Matthias T1 - A new in vitro tool to investigate cardiac contractility under physiological mechanical conditions JF - Journal of Pharmacological and Toxicological Methods Y1 - 2019 U6 - https://doi.org/10.1016/j.vascn.2019.05.162 SN - 1056-8719 VL - 99 IS - Article number 106595 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Leschinger, Tim A1 - Besch, Katharina A1 - Aydin, Cansu A1 - Staat, Manfred A1 - Scaal, Martin A1 - Müller, Lars Peter A1 - Wegmann, Kilian T1 - Irreparable rotator cuff tears: a biomechanical comparison of superior capsuloligamentous complex reconstruction techniques and an interposition graft technique JF - The Orthopaedic Journal of Sports Medicine Y1 - 2019 U6 - https://doi.org/10.1177/2325967119864590 VL - 7 IS - 8 SP - 1 EP - 5 ER - TY - JOUR A1 - Bhattarai, Aroj A1 - Staat, Manfred T1 - A computational study of organ relocation after laparoscopic pectopexy to repair posthysterectomy vaginal vault prolapse JF - Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization Y1 - 2019 U6 - https://doi.org/10.1080/21681163.2019.1670095 SN - 2168-1171 PB - Taylor & Francis CY - London ER - TY - JOUR A1 - Rausch, Valentin A1 - Harbrecht, Andreas A1 - Kahmann, Stephanie Lucina A1 - Fenten, Thomas A1 - Jovanovic, Nebojsa A1 - Hackl, Michael A1 - Müller, Lars P. A1 - Staat, Manfred A1 - Wegmann, Kilian T1 - Osteosynthesis of Phalangeal Fractures: Biomechanical Comparison of Kirschner Wires, Plates, and Compression Screws JF - The Journal of Hand Surgery N2 - Purpose The aim of this study was to compare several osteosynthesis techniques (intramedullary headless compression screws, T-plates, and Kirschner wires) for distal epiphyseal fractures of proximal phalanges in a human cadaveric model. Methods A total of 90 proximal phalanges from 30 specimens (index, ring, and middle fingers) were used for this study. After stripping off all soft tissue, a transverse distal epiphyseal fracture was simulated at the proximal phalanx. The 30 specimens were randomly assigned to 1 fixation technique (30 per technique), either a 3.0-mm intramedullary headless compression screw, locking plate fixation with a 2.0-mm T-plate, or 2 oblique 1.0-mm Kirschner wires. Displacement analysis (bending, distraction, and torsion) was performed using optical tracking of an applied random speckle pattern after osteosynthesis. Biomechanical testing was performed with increasing cyclic loading and with cyclic load to failure using a biaxial torsion-tension testing machine. Results Cannulated intramedullary compression screws showed significantly less displacement at the fracture site in torsional testing. Furthermore, screws were significantly more stable in bending testing. Kirschner wires were significantly less stable than plating or screw fixation in any cyclic load to failure test setup. Conclusions Intramedullary compression screws are a highly stable alternative in the treatment of transverse distal epiphyseal phalangeal fractures. Kirschner wires seem to be inferior regarding displacement properties and primary stability. Clinical relevance Fracture fixation of phalangeal fractures using plate osteosynthesis may have the advantage of a very rigid reduction, but disadvantages such as stiffness owing to the more invasive surgical approach and soft tissue irritation should be taken into account. Headless compression screws represent a minimally invasive choice for fixation with good biomechanical properties. Y1 - 2020 U6 - https://doi.org/10.1016/j.jhsa.2020.04.010 SN - 0363-5023 VL - 45 IS - 10 SP - 987.e1 EP - 987.e8 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Rausch, Valentin A1 - Kahmann, Stephanie Lucina A1 - Baltschun, Christoph A1 - Staat, Manfred A1 - Müller, Lars P. A1 - Wegmann, Kilian T1 - Pressure distribution to the distal biceps tendon at the radial tuberosity: a biomechanical study JF - The Journal of Hand Surgery N2 - Purpose Mechanical impingement at the narrow radioulnar space of the tuberosity is believed to be an etiological factor in the injury of the distal biceps tendon. The aim of the study was to compare the pressure distribution at the proximal radioulnar space between 2 fixation techniques and the intact state. Methods Six right arms and 6 left arms from 5 female and 6 male frozen specimens were used for this study. A pressure transducer was introduced at the height of the radial tuberosity with the intact distal biceps tendon and after 2 fixation methods: the suture-anchor and the cortical button technique. The force (N), maximum pressure (kPa) applied to the radial tuberosity, and the contact area (mm²) of the radial tuberosity with the ulna were measured and differences from the intact tendon were detected from 60° supination to 60° pronation in 15° increments with the elbow in full extension and in 45° and 90° flexion of the elbow. Results With the distal biceps tendon intact, the pressures during pronation were similar regardless of extension and flexion and were the highest at 60° pronation with 90° elbow flexion (23.3 ± 53.5 kPa). After repair of the tendon, the mean peak pressure, contact area, and total force showed an increase regardless of the fixation technique. Highest peak pressures were found using the cortical button technique at 45° flexion of the elbow and 60° pronation. These differences were significantly different from the intact tendon. The contact area was significantly larger in full extension and 15°, 30°, and 60° pronation using the cortical button technique. Conclusions Pressures on the distal biceps tendon at the radial tuberosity increase during pronation, especially after repair of the tendon. Clinical relevance Mechanical impingement could play a role in both the etiology of primary distal biceps tendon ruptures and the complications occurring after fixation of the tendon using certain techniques. Y1 - 2020 U6 - https://doi.org/10.1016/j.jhsa.2020.01.006 SN - 0363-5023 VL - 45 IS - 8 SP - 776.e1 EP - 776.e9 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Knox, Ronald A1 - Bruggemann, Andrea A1 - Gossmann, Matthias A1 - Thomas, Ulrich A1 - Horváth, András A1 - Dragicevic, Elena A1 - Stoelzle-Feix, Sonja A1 - Fertig, Niels A1 - Jung, Alexander A1 - Raman, Aravind Hariharan A1 - Staat, Manfred A1 - Linder, Peter T1 - Combining physiological relevance and throughput for in vitro cardiac contractility measurement JF - Biophysical Journal N2 - Despite increasing acceptance of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) in safety pharmacology, controversy remains about the physiological relevance of existing in vitro models for their mechanical testing. We hypothesize that existing signs of immaturity of the cell models result from an improper mechanical environment. We cultured hiPSC-CMs in a 96-well format on hyperelastic silicone membranes imitating their native mechanical environment, resulting in physiological responses to compound stimuli.We validated cell responses on the FLEXcyte 96, with a set of reference compounds covering a broad range of cellular targets, including ion channel modulators, adrenergic receptor modulators and kinase inhibitors. Acute (10 - 30 min) and chronic (up to 7 days) effects were investigated. Furthermore, the measurements were complemented with electromechanical models based on electrophysiological recordings of the used cell types.hiPSC-CMs were cultured on freely-swinging, ultra-thin and hyperelastic silicone membranes. The weight of the cell culture medium deflects the membranes downwards. Rhythmic contraction of the hiPSC-CMs resulted in dynamic deflection changes which were quantified by capacitive distance sensing. The cells were cultured for 7 days prior to compound addition. Acute measurements were conducted 10-30 minutes after compound addition in standard culture medium. For chronic treatment, compound-containing medium was replaced daily for up to 7 days. Electrophysiological properties of the employed cell types were recorded by automated patch-clamp (Patchliner) and the results were integrated into the electromechanical model of the system.Calcium channel agonist S Bay K8644 and beta-adrenergic stimulator isoproterenol induced significant positive inotropic responses without additional external stimulation. Kinase inhibitors displayed cardiotoxic effects on a functional level at low concentrations. The system-integrated analysis detected alterations in beating shape as well as frequency and arrhythmic events and we provide a quantitative measure of these. Y1 - 2020 U6 - https://doi.org/10.1016/j.bpj.2019.11.3104 SN - 0006-3495 N1 - Raman, Arayind Hariharan im Artikel unter dem Namen: Raman, Alexander H. VL - 118 IS - Issue 3, Supplement 1 SP - 570a PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Topçu, Murat A1 - Madabhushi, Gopal S.P. A1 - Staat, Manfred T1 - A generalized shear-lag theory for elastic stress transfer between matrix and fibres having a variable radius JF - International Journal of Solids and Structures N2 - A generalized shear-lag theory for fibres with variable radius is developed to analyse elastic fibre/matrix stress transfer. The theory accounts for the reinforcement of biological composites, such as soft tissue and bone tissue, as well as for the reinforcement of technical composite materials, such as fibre-reinforced polymers (FRP). The original shear-lag theory proposed by Cox in 1952 is generalized for fibres with variable radius and with symmetric and asymmetric ends. Analytical solutions are derived for the distribution of axial and interfacial shear stress in cylindrical and elliptical fibres, as well as conical and paraboloidal fibres with asymmetric ends. Additionally, the distribution of axial and interfacial shear stress for conical and paraboloidal fibres with symmetric ends are numerically predicted. The results are compared with solutions from axisymmetric finite element models. A parameter study is performed, to investigate the suitability of alternative fibre geometries for use in FRP. KW - Natural fibres KW - Polymer-matrix composites KW - Biocomposites KW - Stress concentrations KW - Finite element analysis Y1 - 2022 U6 - https://doi.org/10.1016/j.ijsolstr.2022.111464 SN - 0020-7683 VL - 239–240 IS - Art. No. 111464 PB - Elsevier CY - New York, NY ER - TY - JOUR A1 - Defosse, Jerome A1 - Kleinschmidt, Joris A1 - Schmutz, Axel A1 - Loop, Torsten A1 - Staat, Manfred A1 - Gatzweiler, Karl-Heinz A1 - Wappler, Frank A1 - Schieren, Mark T1 - Dental strain on maxillary incisors during tracheal intubation with double-lumen tubes and different laryngoscopy techniques - a blinded manikin study JF - Journal of Cardiothoracic and Vascular Anesthesia KW - anaesthetic complications KW - dental trauma KW - difficult airway KW - double-lumen tube intubation KW - videolaryngoscopy Y1 - 2022 U6 - https://doi.org/10.1053/j.jvca.2022.02.017 SN - 1053-0770 VL - 36 IS - 8, Part B SP - 3021 EP - 3027 PB - Elsevier CY - New York, NY ER - TY - JOUR A1 - Bhattarai, Aroj A1 - May, Charlotte Anabell A1 - Staat, Manfred A1 - Kowalczyk, Wojciech A1 - Tran, Thanh Ngoc T1 - Layer-specific damage modeling of porcine large intestine under biaxial tension JF - Bioengineering N2 - The mechanical behavior of the large intestine beyond the ultimate stress has never been investigated. Stretching beyond the ultimate stress may drastically impair the tissue microstructure, which consequently weakens its healthy state functions of absorption, temporary storage, and transportation for defecation. Due to closely similar microstructure and function with humans, biaxial tensile experiments on the porcine large intestine have been performed in this study. In this paper, we report hyperelastic characterization of the large intestine based on experiments in 102 specimens. We also report the theoretical analysis of the experimental results, including an exponential damage evolution function. The fracture energies and the threshold stresses are set as damage material parameters for the longitudinal muscular, the circumferential muscular and the submucosal collagenous layers. A biaxial tensile simulation of a linear brick element has been performed to validate the applicability of the estimated material parameters. The model successfully simulates the biomechanical response of the large intestine under physiological and non-physiological loads. KW - biaxial tensile experiment KW - anisotropy KW - hyperelastic KW - constitutive modeling KW - damage Y1 - 2022 U6 - https://doi.org/10.3390/bioengineering9100528 SN - 2306-5354 N1 - Der Artikel gehört zum Sonderheft "Computational Biomechanics" VL - 9 IS - 10, Early Access SP - 1 EP - 17 PB - MDPI CY - Basel ER - TY - JOUR A1 - Colombo, Daniele A1 - Drira, Slah A1 - Frotscher, Ralf A1 - Staat, Manfred T1 - An element-based formulation for ES-FEM and FS-FEM models for implementation in standard solid mechanics finite element codes for 2D and 3D static analysis JF - International Journal for Numerical Methods in Engineering N2 - Edge-based and face-based smoothed finite element methods (ES-FEM and FS-FEM, respectively) are modified versions of the finite element method allowing to achieve more accurate results and to reduce sensitivity to mesh distortion, at least for linear elements. These properties make the two methods very attractive. However, their implementation in a standard finite element code is nontrivial because it requires heavy and extensive modifications to the code architecture. In this article, we present an element-based formulation of ES-FEM and FS-FEM methods allowing to implement the two methods in a standard finite element code with no modifications to its architecture. Moreover, the element-based formulation permits to easily manage any type of element, especially in 3D models where, to the best of the authors' knowledge, only tetrahedral elements are used in FS-FEM applications found in the literature. Shape functions for non-simplex 3D elements are proposed in order to apply FS-FEM to any standard finite element. KW - distorted element KW - ES-FEM KW - FS-FEM KW - non-simplex S-FEM elements KW - S-FEM Y1 - 2022 U6 - https://doi.org/10.1002/nme.7126 SN - 1097-0207 VL - 124 IS - 2 SP - 402 EP - 433 PB - Wiley CY - Chichester ER - TY - JOUR A1 - Tran, Ngoc Trinh A1 - Trinh, Tu Luc A1 - Dao, Ngoc Tien A1 - Giap, Van Tan A1 - Truong, Manh Khuyen A1 - Dinh, Thuy Ha A1 - Staat, Manfred T1 - FEM shakedown analysis of structures under random strength with chance constrained programming JF - Vietnam Journal of Mechanics N2 - Direct methods, comprising limit and shakedown analysis, are a branch of computational mechanics. They play a significant role in mechanical and civil engineering design. The concept of direct methods aims to determine the ultimate load carrying capacity of structures beyond the elastic range. In practical problems, the direct methods lead to nonlinear convex optimization problems with a large number of variables and constraints. If strength and loading are random quantities, the shakedown analysis can be formulated as stochastic programming problem. In this paper, a method called chance constrained programming is presented, which is an effective method of stochastic programming to solve shakedown analysis problems under random conditions of strength. In this study, the loading is deterministic, and the strength is a normally or lognormally distributed variable. KW - limit analysis KW - shakedown analysis KW - chance constrained programming KW - stochastic programming KW - reliability of structures Y1 - 2022 U6 - https://doi.org/10.15625/0866-7136/17943 SN - 0866-7136 SN - 2815-5882 VL - 44 IS - 4 SP - 459 EP - 473 PB - Vietnam Academy of Science and Technology (VAST) ER - TY - JOUR A1 - Levers, A. A1 - Staat, Manfred A1 - Laack, Walter van T1 - Analysis of the long-term effect of the MBST® nuclear magnetic resonance therapy on gonarthrosis JF - Orthopedic Practice Y1 - 2016 VL - 47 IS - 11 SP - 521 EP - 528 ER - TY - JOUR A1 - Jayaraman, Chandrasekaran A1 - Mummidisetty, Chaitanya Krishna A1 - Loesch, Alexandra A1 - Kaur, Sandi A1 - Hoppe-Ludwig, Shenan A1 - Staat, Manfred A1 - Jayaraman, Arun T1 - Postural and metabolic benefits of using a forearm support walker in older adults with impairments JF - Archives of Physical Medicine and Rehabilitation Y1 - 2019 U6 - https://doi.org/10.1016/j.apmr.2018.10.001 SN - 0003-9993 VL - Volume 100 IS - Issue 4 SP - 638 EP - 647 PB - Elsevier CY - Amsterdam ER -