Barriers to correct child restraint use: A qualitative study of child restraint users and their needs

Hall, Alexandra; Ho, Catherine; Keay, Lisa; McCaffery, Kirsten; Hunter, Kate; Charlton, Judith; Hayen, Andrew; Bilston, Lynne E.; Brown, Julie · 2018 · OpenAlex-citations

DOI: 10.1016/j.ssci.2018.05.017

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Summary

This review article examines contemporary image-based methods for quantifying the passive mechanical properties and architecture of skeletal muscles in vivo. The authors address the complexity of skeletal muscle as an anisotropic, nonlinearly viscoelastic tissue, noting that while active muscle properties are well-studied, passive mechanics are critical for understanding physiology and pathology. The paper evaluates four primary imaging techniques: Magnetic Resonance Elastography (MRE), Ultrasound Shear Wave Elastography (SWE), Dynamic MRI, and Diffusion Tensor Imaging (DTI). The goal is to provide a critical evaluation of the strengths, limitations, and clinical applications of these methods for both healthy subjects and patient populations. MRE and SWE are used to map passive mechanical parameters such as elasticity and viscosity. MRE applies external vibrations synchronized with MRI to calculate shear modulus maps, offering 3D spatial resolution but suffering from long acquisition times, lack of standardization, and sensitivity to muscle loading states. Recent advancements allow for anisotropic MRE, which accounts for muscle fiber direction, though robust analysis methods remain a challenge. SWE uses ultrasound to track shear wave propagation, offering higher temporal resolution and lower cost than MRE. It enables rapid measurements during passive stretching or low-level contractions, facilitating the study of nonlinear muscle behavior. However, SWE is limited to 2D measurements, making it difficult to assess anisotropy in pennate muscles, and requires operator expertise to ensure reliability. Dynamic MRI methods, including velocity-encoded phase-contrast, displacement-encoded imaging, and MR tagging, characterize regional muscle deformation during motion. These techniques quantify strain and strain rate tensors, providing insights into internal muscle mechanics that global measures miss. While they offer detailed kinematic data, they are not real-time and rely on motion repeatability. Applications include studying age-related changes, disuse atrophy, and injury risk factors, such as localized elevated strains in hamstring muscles. DTI complements these methods by measuring 3D muscle architecture and fiber orientation through water diffusion patterns. DTI provides high-resolution structural data essential for computational modeling and assessing architectural changes in disorders like Duchenne Muscular Dystrophy. However, DTI is limited to static measurements and can be confounded by intramuscular fat in diseased tissues. The significance of this review lies in synthesizing how these complementary imaging techniques advance the understanding of skeletal muscle function. By combining mechanical property mapping (MRE, SWE), dynamic deformation analysis (Dynamic MRI), and structural characterization (DTI), researchers can better diagnose and monitor muscle disorders, including degeneration, injury, and the effects of aging. The authors highlight that while each method has specific limitations regarding standardization, resolution, or acquisition time, their combined use offers a comprehensive approach to characterizing the complex mechanical behavior of skeletal muscles in clinical and biomechanical research.

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