The use of external transducers for estimating bone strain at the distal tibia during impact activity

Noninvasive methods for monitoring the in vivo loading environment of human bone are needed to determine osteogenic loading patterns that reduce the potential for bone injury. The purpose of this study was to determine whether the vertical ground reaction impact force (impact force) and leg acceleration could be used to estimate internal bone strain at the distal tibia during impact activity. Impact loading was delivered to the heels of human-cadaveric lower extremities. The effects of impact mass and contact velocity on peak bone strain, impact force, leg acceleration, and computed impact force (leg acceleration *impact mass) were investigated. Regression analysis was used to predict bone strain from six different models. Apart from leg acceleration, all variables responded to impact loading similarly. Increasing impact mass resulted in increased bone strain, impact force, and computed impact force, but decreased leg acceleration. The best models for bone strain prediction included impact force and tibial cross-sectional area (R(2)=0.94), computed impact force and tibial cross-sectional area (R(2)=0.84), and leg acceleration and tibial cross-sectional area (R(2)=0.73). Results demonstrate that when attempting to estimate bone strain from external transducers some measure of bone strength must be considered. Although it is not recommended that the prediction equations developed in this study be used to predict bone strain in vivo, the strong relationship between bone strain, impact force, and computed impact force suggested that force platforms and leg accelerometers can be used for a surrogate measure of bone strain.