**7. Biomechanics in the chain of driving phenomena and movement consequences**

The ability to maintain balance and the ability to navigate in the outdoor based on specific markers, including the sun, have been well established in simple nervous systems of insects [60]. However, referring to the earlier discussion, human physical activity covers a broad set of behaviors related not only to maintaining balance but also to the locomotion specificity, facial expressions, speech, and voluntary movements of varying complexity. A stable posture is a prerequisite for the majority of voluntary movements, locomotors, and creative activities. The describable human body motion should be treated as a chain of mutually coupled procedures: perceptive, decision-making, control, motor, and systemically interactive and correlated with internal and external reference system. The biomechanical (dynamic) description is a set of parametric sequences of timesynchronized shift vectors of specific marker points [61, 62]. Movement anatomy should be recorded and evaluated in full anthropomotorical context, at least in four categories:


Practical attempts undertaken by the authors in this regard have been successful [63–65].

Adopting an upright position is a reflex action, based on evolutionary and ontogenetically reproduced postural reflexes. Evolution has created a universal movement calibration system using a gravity arrow available all over the planet. The resulting habit of referring motion vectors to a universal direction (even in the darkness) is one of the last stages of mastering and improving motor skills, which allow for a multiple repetition of motor task in a similar manner without involving the consciousness. In children aged 7–11 years, there is an escalation in the development of balance capacities, which is probably never repeated again. The manifestation of unconditional reflexes in this period induces the child to experiment with motion and consequently leads to the formation of individual conditional reflexes, then dynamic stereotypes, and eventually motor habits. Due to the fact that a little later, between 11 and 13 years, there is a period of temporary stagnation or even partial regression of internalized behaviors, it is very important for schoolchildren to have a well-thought-out training, focused on developing coordination and balance skills.

The main area of research in contemporary anthropomotorics is the search for a motion control model and defining methods of encoding information in these models [6, 66, 67]. Drawing inspiration from the mathematical description of the methods for rigid bodies, it is worth remembering the significant differences between the machine and a living organism. A machine, described globally or at subsequent stages of the sequence of its components, performs a specific move (always in the same manner), precisely predetermined by the design plan as well as by the control variant chosen. These features are clearly defined by the machine's working element in the number of degrees of freedom, and the applied constraints accurately determine the specificity of the working track, which will be implemented (with the same parameters) for any number of repetitions. Living organisms can achieve a similar kinematic goal, for which they use an interactive sensorimotor procedure; however, in view of the necessity for a greater number of repetitions, they carry out experiments in the field of kinematic path control (from state A to state B). These experiments consist in attempts to reduce degrees of freedom in the movement control procedure, which also means the reduction in the number of muscles involved and energy saving in consequence (Bernstein). Improving the kinematic forms of movement while reducing energy consumption leads to optimization in the species development of living organisms [68].

It is worth adding that after a thorough, cytoarchitectonic definition of a large part of the cortical sensory fields, which have a strictly defined anatomical relationship with the ascending spinal cord pathways and receptors, as well as the cortical motor fields associated with the descending spinal cord pathways and muscle effectors, a research for functional relationships of higher order between different parts of the cortex began [23].

The above processes for the reduction of degrees of freedom, which aimed to optimize human and animal movements, are described by Bernstein in his theory of control levels. This theory seeks to outline and highlight within the central nervous system (CNS) a specific number of hierarchically associated classes of functional creations, responsible for movement creation of certain specificity, which significantly decreases probability of a control error [69]. Gradually, a cause-and-effect relationship of four factors that determine mobility began to emerge:


**55**

*Biomechanics as an Element of the Motion Clinimetry System*

emergence of new executive organs, as well as emergence of new formations in

c.Optimization (development of versatile sensorimotor capabilities that enable

d.Sensorimotor intelligence (cleverness, artfulness, and agility combined with prospective calculation of motor task in the context of the structures and entities recognized in the foreground and background of the subject's physical

Initially, a good reflection of it was Bernstein's model, consisting of five hierarchically coupled levels of motion control, trying to find constituent components in complex movements: (A) muscle tension, (B) muscle synergy, (C) spatial field, (D) complex activities, and (E) symbolic operations. Such an arrangement partly explains the follow-up functions of the extrapyramidal system, which adjusts the geometry of angular parameters of the body's rigid modules (bones-joints) and the degree of the bond stiffness (joints) and viscoelastic systems (muscles), in order to maintain balance in the gravitational field, regardless the temporary destabilization of one of the modules of the body (e.g., hand) performing a conscious movement [71]. According to this theory, the system of levels is configured hierarchically, from superficial to profound layers. This direction is caused by the integrating function of layers D to E, which stimulate performance of the motor task components without involving conscious attention. For these levels of movement structure, there have been introduced various control models, for example, for (B), Gibson's ecological model; for (C), the hypothesis of an equilibrium point; and for (D), Schmidt's cybernetic model. Moreover, for reality mapping and motion control, levels A, B, and C use sensory code, while levels D and E use symbolic code of

The introduction of electronic inventions into biomechanics caused an avalanche of new discoveries in the field of motion kinematics, and it became necessary to modify Bernstein's theory, where instead of a static, layered system of control levels, a dynamic model has been introduced, whose subsequent layers overlap to form transition zones. This new feature well explains the fact that the development of individual levels proceeds gradually, beginning with the emergence of new perceptive abilities and only then of new motor skills. It was assumed that the new level of perception may to some extent define the demand for cooperation with the structures having simpler coordination engrams, which may be a factor that powers the development of sensorimotor and control abilities. In addition, it was assumed that, stimulated with need, a lower level of motor behavior organization, having used up all available range of options, may command the higher level to seek for more optimal motor compositions, as it possesses greater associative capabilities. In this model, there is thus a two-way flow of directives regarding functioning, namely, from the top to the bottom (in order to include simple coordination engrams in the complex, three-dimensional diagrams) or from the bottom to the top (in order to adapt existing, underlying motion engrams to the new kine-

In the complex procedure of balance creation, the cerebellum receives and triggers information from the labyrinth receptors, proprioreceptors, extroceptors, and telereceptors in the functional buffer, thus forming multi-loop models, which are electric-resonant equilibrium equivalent at T1, T2, etc., Tn. These models are confronted with many equilibrium patterns; they create corrective engrams that

the CNS, enabling the creation of new sensorimotor abilities)

building new skills in terms of complex motor tasks)

*DOI: http://dx.doi.org/10.5772/intechopen.92757*

environment) [22, 70]

motion representations [20].

matic situation in a given environment).

*Recent Advances in Biomechanics*

ance skills.

development of living organisms [68].

parts of the cortex began [23].

Adopting an upright position is a reflex action, based on evolutionary and ontogenetically reproduced postural reflexes. Evolution has created a universal movement calibration system using a gravity arrow available all over the planet. The resulting habit of referring motion vectors to a universal direction (even in the darkness) is one of the last stages of mastering and improving motor skills, which allow for a multiple repetition of motor task in a similar manner without involving the consciousness. In children aged 7–11 years, there is an escalation in the development of balance capacities, which is probably never repeated again. The manifestation of unconditional reflexes in this period induces the child to experiment with motion and consequently leads to the formation of individual conditional reflexes, then dynamic stereotypes, and eventually motor habits. Due to the fact that a little later, between 11 and 13 years, there is a period of temporary stagnation or even partial regression of internalized behaviors, it is very important for schoolchildren to have a well-thought-out training, focused on developing coordination and bal-

The main area of research in contemporary anthropomotorics is the search for a motion control model and defining methods of encoding information in these models [6, 66, 67]. Drawing inspiration from the mathematical description of the methods for rigid bodies, it is worth remembering the significant differences between the machine and a living organism. A machine, described globally or at subsequent stages of the sequence of its components, performs a specific move (always in the same manner), precisely predetermined by the design plan as well as by the control variant chosen. These features are clearly defined by the machine's working element in the number of degrees of freedom, and the applied constraints accurately determine the specificity of the working track, which will be implemented (with the same parameters) for any number of repetitions. Living organisms can achieve a similar kinematic goal, for which they use an interactive sensorimotor procedure; however, in view of the necessity for a greater number of repetitions, they carry out experiments in the field of kinematic path control (from state A to state B). These experiments consist in attempts to reduce degrees of freedom in the movement control procedure, which also means the reduction in the number of muscles involved and energy saving in consequence (Bernstein). Improving the kinematic forms of movement while reducing energy consumption leads to optimization in the species

It is worth adding that after a thorough, cytoarchitectonic definition of a large part of the cortical sensory fields, which have a strictly defined anatomical relationship with the ascending spinal cord pathways and receptors, as well as the cortical motor fields associated with the descending spinal cord pathways and muscle effectors, a research for functional relationships of higher order between different

The above processes for the reduction of degrees of freedom, which aimed to optimize human and animal movements, are described by Bernstein in his theory of control levels. This theory seeks to outline and highlight within the central nervous system (CNS) a specific number of hierarchically associated classes of functional creations, responsible for movement creation of certain specificity, which significantly decreases probability of a control error [69]. Gradually, a cause-and-effect

relationship of four factors that determine mobility began to emerge:

a.Excitability (ability to receive and respond to environmental stimuli)

b.Analysis of the environment and creationism (perception of new motor tasks and the need to solve them, which leads to the development of existing or

**54**

emergence of new executive organs, as well as emergence of new formations in the CNS, enabling the creation of new sensorimotor abilities)


Initially, a good reflection of it was Bernstein's model, consisting of five hierarchically coupled levels of motion control, trying to find constituent components in complex movements: (A) muscle tension, (B) muscle synergy, (C) spatial field, (D) complex activities, and (E) symbolic operations. Such an arrangement partly explains the follow-up functions of the extrapyramidal system, which adjusts the geometry of angular parameters of the body's rigid modules (bones-joints) and the degree of the bond stiffness (joints) and viscoelastic systems (muscles), in order to maintain balance in the gravitational field, regardless the temporary destabilization of one of the modules of the body (e.g., hand) performing a conscious movement [71]. According to this theory, the system of levels is configured hierarchically, from superficial to profound layers. This direction is caused by the integrating function of layers D to E, which stimulate performance of the motor task components without involving conscious attention. For these levels of movement structure, there have been introduced various control models, for example, for (B), Gibson's ecological model; for (C), the hypothesis of an equilibrium point; and for (D), Schmidt's cybernetic model. Moreover, for reality mapping and motion control, levels A, B, and C use sensory code, while levels D and E use symbolic code of motion representations [20].

The introduction of electronic inventions into biomechanics caused an avalanche of new discoveries in the field of motion kinematics, and it became necessary to modify Bernstein's theory, where instead of a static, layered system of control levels, a dynamic model has been introduced, whose subsequent layers overlap to form transition zones. This new feature well explains the fact that the development of individual levels proceeds gradually, beginning with the emergence of new perceptive abilities and only then of new motor skills. It was assumed that the new level of perception may to some extent define the demand for cooperation with the structures having simpler coordination engrams, which may be a factor that powers the development of sensorimotor and control abilities. In addition, it was assumed that, stimulated with need, a lower level of motor behavior organization, having used up all available range of options, may command the higher level to seek for more optimal motor compositions, as it possesses greater associative capabilities. In this model, there is thus a two-way flow of directives regarding functioning, namely, from the top to the bottom (in order to include simple coordination engrams in the complex, three-dimensional diagrams) or from the bottom to the top (in order to adapt existing, underlying motion engrams to the new kinematic situation in a given environment).

In the complex procedure of balance creation, the cerebellum receives and triggers information from the labyrinth receptors, proprioreceptors, extroceptors, and telereceptors in the functional buffer, thus forming multi-loop models, which are electric-resonant equilibrium equivalent at T1, T2, etc., Tn. These models are confronted with many equilibrium patterns; they create corrective engrams that

cause the evolution of motion of the body center of gravity to the central area of the critical curve of the supporting plane. When the pyramidal paths are activated by the control sequence of conscious movement, especially when there is a significant shift of the center of gravity, it activates the independent, multi-muscular movement sequence, causing balance correction [72].

#### **7.1 Perception and gnosia**

A perceptive-gnostic procedure occurs in the human CNS (and probably in many other vertebrates), and despite the fact it includes projection engrams, simple and complex perceptual engrams, gnostic engrams, model intentional engrams, and decision-executive engrams, it is not available for measurement systems of classical biomechanics. In this procedure, in a specified period of time, stimuli are projected from proprioceptive receptors (strain gauges, located in tendons, muscles, and ligaments), extroceptors (skin sensation), and telereceptors (balance organs—gyroscopic accelerometers, retina, eye receptors). In areas of the sensory cortex, anatomically associated with the appropriate type of receptors, electricresonance, loop equivalents of phenomena recorded by the receptors are created, namely, projection proprioceptive simulation, projection extroceptor simulation, projection telereceptor-gravitometric simulation, and projection telereceptor-visual simulation simulator. During this time, cognitive processes also occur, referring the resulting projective equivalents to the appropriate pattern bases, resulting in the creation of gnosia, or engrams with the meaning defined for the subject.

#### *7.1.1 Resonance functional integration model*

Illustratively, one could call these cerebral, loop-electro-resonance equivalents of phenomena recorded by receptors, for example, proprioceptor-cognitive simulation, exteroceptor-cognitive simulation, gravitational-cognitive simulation, visualcognitive simulation, and auditory-cognitive simulation. The three-dimensional association on the common timeline of local, organ-specific electro-resonance models of receptor perception and gnosia results in the creation of a conscious, multilevel conjugated cognitive simulation, which is a representation of a body model integrated into the model of the environment, with particular emphasis on sensory receptor density zones within the eyes, mouth, tongue, and fingers. Corrected by gravitational and geometric markers of the environment, model equivalents of sensory phenomena in the cortex of the brain give the possibility of reflex orientation of the head and long axis of the trunk and extremities in relation to the gravity arrow. The first step to gaining the awareness of being is the perception of the model presented above, determining the geometrical features of the shape of one's own body and the environment, as well as proportional relations between the elements of the environment and the body. Therefore, the model gives a sense of the shape and integrity of the subject's body functions in relation to the three main space vectors and components of the internal environment.

It is worth adding that the conditioning of the emergence of consciousness, the subtle state of simultaneous, inter-center synchronization for the cortical projection and gnostic structures of the brain, requires an independent timing system that determines the excitation (specific resonance frequency) of the simultaneous activity of specific brain areas, constituting the electron resonance generating neural medium in a given time-interval loop of currently interfering components of a conscious being. In the model proposed by the authors, the timing system, using a specific, unique frequency, synchronizes interference groups of neurons to a synchronous electrical activity. A spatial, three-dimensional, subtle interference space

**57**

*Biomechanics as an Element of the Motion Clinimetry System*

way of competition or probabilistic autocreation [73].

a functional access to the pyramidal tract [77–79].

**7.2 Decision-making procedure**

is created, composed of variable electric fields of neurons, for which the criterion of integrity in relation to other (surrounding) nerve cells is a specific resonance frequency. An important criterion for the functioning of consciousness, in terms of the clock frequency of the timing system, seems to be the limiting frequency conditioning the overlap of the descending edge of the dying pulse on the leading edge of the next pulse. In the proposed model, there is a resonant coupling with a set of cortical, projection-gnostic representations of specific receptors or decoupling, which allows the transfer of conscious attention from one area of receptor gnosia to

The association of internal reference system parameters with external reference system parameters in a synchronous manner with the internal awareness timing system makes it possible to define parameters for the last in the sequence of a motion event—the endpoint controllability [71]. It seems that the registration of the end position signal for the motor coordination engram (which currently has exclusive access to the neural space of the pyramidal pathways) releases him from the position of a leader and activates the mechanism of changing the engram, by

As already mentioned, an important element of the consciousness model is the qualitative recognition of the specific features of the model projection of receptors, based on their relation to the relational database in the memory of the subject and after obtaining the conjunction—recognized as specific structures or phenomena. Perception allows to create geometric relationships between one's own body dimensions and the elements of the environment, as well as emotional relationships in relation to one's own body and its relationships with other subjects and the surrounding structures [74]. The decision-making procedure is based, inter alia, on the recognition and classification of surrounding objects in terms of the possibility of their use for the implementation of a specific task. The predefined gnostic parameters determine the structure and range of operation of the seeking system in order to isolate an adequate executive engram, characterized by a stable structure [75]. This involves a whole range of applicable motor strategies that aim to solve specific motor tasks. The brain has or, in a probabilistic dimension, creates a number of alternative strategies for sequential-functional control of muscle groups, which are concepts for solving a planned vision of a kinematic situation [6]. They are created as intentional models of movement that compete for access to the area in control of neuromuscular system in the motor cortex. The neural network makes a directional selection of models, using (as criteria) parametric data acquired from both exterior and interior of the body, choosing the most optimal algorithm in a given kinematic situation [71, 76]. Once given the priority, the selected model becomes an engram of motion creation and takes over the control of the motor cortex, thereby yielding

The control procedure, which is an engram containing a set of time-oriented motoneuron control procedures, is sent efferently through many parallel pyramidal pathways, stimulating the muscles to a conscious, coordinated movement [80, 81]. Motor procedure—the stimulated part of the muscular system—derives energy from the stored high-energy phosphates only in the first seconds of contraction, and further maintenance of physical activity depends on the efficiency of stimulating the Krebs cycle oxidative reactions, as well as efficiency in the removal of the waste products. The above example gives an idea about the interference depth of kinematic stimuli in the body's molecular phenomena. The interactive procedure systemically affects the biomechanical consequences of intentional movement that

*DOI: http://dx.doi.org/10.5772/intechopen.92757*

another.

#### *Biomechanics as an Element of the Motion Clinimetry System DOI: http://dx.doi.org/10.5772/intechopen.92757*

*Recent Advances in Biomechanics*

**7.1 Perception and gnosia**

ment sequence, causing balance correction [72].

*7.1.1 Resonance functional integration model*

cause the evolution of motion of the body center of gravity to the central area of the critical curve of the supporting plane. When the pyramidal paths are activated by the control sequence of conscious movement, especially when there is a significant shift of the center of gravity, it activates the independent, multi-muscular move-

A perceptive-gnostic procedure occurs in the human CNS (and probably in many other vertebrates), and despite the fact it includes projection engrams, simple and complex perceptual engrams, gnostic engrams, model intentional engrams, and decision-executive engrams, it is not available for measurement systems of classical biomechanics. In this procedure, in a specified period of time, stimuli are projected from proprioceptive receptors (strain gauges, located in tendons, muscles, and ligaments), extroceptors (skin sensation), and telereceptors (balance organs—gyroscopic accelerometers, retina, eye receptors). In areas of the sensory cortex, anatomically associated with the appropriate type of receptors, electricresonance, loop equivalents of phenomena recorded by the receptors are created, namely, projection proprioceptive simulation, projection extroceptor simulation, projection telereceptor-gravitometric simulation, and projection telereceptor-visual simulation simulator. During this time, cognitive processes also occur, referring the resulting projective equivalents to the appropriate pattern bases, resulting in the

creation of gnosia, or engrams with the meaning defined for the subject.

space vectors and components of the internal environment.

Illustratively, one could call these cerebral, loop-electro-resonance equivalents of phenomena recorded by receptors, for example, proprioceptor-cognitive simulation, exteroceptor-cognitive simulation, gravitational-cognitive simulation, visualcognitive simulation, and auditory-cognitive simulation. The three-dimensional association on the common timeline of local, organ-specific electro-resonance models of receptor perception and gnosia results in the creation of a conscious, multilevel conjugated cognitive simulation, which is a representation of a body model integrated into the model of the environment, with particular emphasis on sensory receptor density zones within the eyes, mouth, tongue, and fingers. Corrected by gravitational and geometric markers of the environment, model equivalents of sensory phenomena in the cortex of the brain give the possibility of reflex orientation of the head and long axis of the trunk and extremities in relation to the gravity arrow. The first step to gaining the awareness of being is the perception of the model presented above, determining the geometrical features of the shape of one's own body and the environment, as well as proportional relations between the elements of the environment and the body. Therefore, the model gives a sense of the shape and integrity of the subject's body functions in relation to the three main

It is worth adding that the conditioning of the emergence of consciousness, the subtle state of simultaneous, inter-center synchronization for the cortical projection and gnostic structures of the brain, requires an independent timing system that determines the excitation (specific resonance frequency) of the simultaneous activity of specific brain areas, constituting the electron resonance generating neural medium in a given time-interval loop of currently interfering components of a conscious being. In the model proposed by the authors, the timing system, using a specific, unique frequency, synchronizes interference groups of neurons to a synchronous electrical activity. A spatial, three-dimensional, subtle interference space

**56**

is created, composed of variable electric fields of neurons, for which the criterion of integrity in relation to other (surrounding) nerve cells is a specific resonance frequency. An important criterion for the functioning of consciousness, in terms of the clock frequency of the timing system, seems to be the limiting frequency conditioning the overlap of the descending edge of the dying pulse on the leading edge of the next pulse. In the proposed model, there is a resonant coupling with a set of cortical, projection-gnostic representations of specific receptors or decoupling, which allows the transfer of conscious attention from one area of receptor gnosia to another.

The association of internal reference system parameters with external reference system parameters in a synchronous manner with the internal awareness timing system makes it possible to define parameters for the last in the sequence of a motion event—the endpoint controllability [71]. It seems that the registration of the end position signal for the motor coordination engram (which currently has exclusive access to the neural space of the pyramidal pathways) releases him from the position of a leader and activates the mechanism of changing the engram, by way of competition or probabilistic autocreation [73].

#### **7.2 Decision-making procedure**

As already mentioned, an important element of the consciousness model is the qualitative recognition of the specific features of the model projection of receptors, based on their relation to the relational database in the memory of the subject and after obtaining the conjunction—recognized as specific structures or phenomena. Perception allows to create geometric relationships between one's own body dimensions and the elements of the environment, as well as emotional relationships in relation to one's own body and its relationships with other subjects and the surrounding structures [74]. The decision-making procedure is based, inter alia, on the recognition and classification of surrounding objects in terms of the possibility of their use for the implementation of a specific task. The predefined gnostic parameters determine the structure and range of operation of the seeking system in order to isolate an adequate executive engram, characterized by a stable structure [75].

This involves a whole range of applicable motor strategies that aim to solve specific motor tasks. The brain has or, in a probabilistic dimension, creates a number of alternative strategies for sequential-functional control of muscle groups, which are concepts for solving a planned vision of a kinematic situation [6]. They are created as intentional models of movement that compete for access to the area in control of neuromuscular system in the motor cortex. The neural network makes a directional selection of models, using (as criteria) parametric data acquired from both exterior and interior of the body, choosing the most optimal algorithm in a given kinematic situation [71, 76]. Once given the priority, the selected model becomes an engram of motion creation and takes over the control of the motor cortex, thereby yielding a functional access to the pyramidal tract [77–79].

The control procedure, which is an engram containing a set of time-oriented motoneuron control procedures, is sent efferently through many parallel pyramidal pathways, stimulating the muscles to a conscious, coordinated movement [80, 81]. Motor procedure—the stimulated part of the muscular system—derives energy from the stored high-energy phosphates only in the first seconds of contraction, and further maintenance of physical activity depends on the efficiency of stimulating the Krebs cycle oxidative reactions, as well as efficiency in the removal of the waste products. The above example gives an idea about the interference depth of kinematic stimuli in the body's molecular phenomena. The interactive procedure systemically affects the biomechanical consequences of intentional movement that

could threaten the balance of the whole body. This procedure forces involuntary, follow-up reflexes from the extrapyramidal system, which modulate skeletal muscle tone in different parts of the body, allowing to maintain the balance and constant direction in relation to the gravity vector. A living organism, in contrast to a comparable (in terms of size) and stable (in given circumstances) crystal structure, is a visco-elastic body that changes its characteristics locally, rather than in a way that would be optimally adapted to the forces acting from the outside. Every kinematic situation, which can be described using a simple marker geometry, has a qualitatively different way of linking active information conveyors (nerves), energy converters (muscles), and the blood distribution, which conditions the efficiency of locally intensified metabolism. Local blood distribution profile is connected with ion concentration changes, which by means of the changing tissue resistance, impedance, and magnetic induction influence the sensitivity of the skin sensors. These parameters can be registered using electrodiagnostic methods, such as ECG, EEG, EMG, ENG, and EEA. It can therefore be assumed that each of the organ pairs existing in a living body, despite their high degree of structural and functional autonomy, functions in an information-coupled way through mirror elements of the nervous system and also in a hormone-distribution-coupled way, realized through the vascular system. In order to obtain a complete dysfunction image, it is therefore not sufficient to merely evidence asymmetries in the goniometric tests, as neurogenic, vascular, and immunological causative factors should also be taken into account.

#### **7.3 Control strategy**

One of the control strategies aimed at maintaining the general symmetry plan within a pair of organs is their individual endeavor to develop their own existence, which manifests itself in the competition for access to the distribution of nutrients and a tendency for constant reconstruction and redevelopment. In case of damage in one part of an organ pair in the nervous system, at least two basic survival strategies are launched, the first of which consists in intensification of the vascular perfusion and activation of neuronal paracrine secretion, conducive to hypertrophy and hyperplasia of cells in the damaged organ. The second strategy consists in increasing the metabolic efficiency of an intact organ, increasing its contribution to maintaining steadiness of parametric balance at the central level. Organ reflexes for the first strategy are located at the level of the lowest spinal cord integrators and for the second at the level of high spinal cord integrators and hypothalamus [82, 83].

The algorithms shaping motor and metabolic coordination in a living organism are interactive, held under the form of the convergent or opposing oscillations around certain equilibrium points. The extent of this oscillation, being the body's response to the changing environmental stimuli, depends on regulatory efficiency on kinematic, computer, and metabolic level of the system. A young organism, not having many coordination engrams, reacts cautiously, using a large number of oscillations with high parametric amplitudes, trying to optimize to the equilibrium points. A mature organism, having a shaped profile of movement strategies, adapts its behavior to the situation a lot faster and moreover in a balanced and elegant manner.

Cellular homeostasis manifests itself by an individual cell's ability to develop functional states with parameters that pose no threat to the system itself. Its higher level—the tissue homeostasis—is a feedback of many metabolic oscillators, whose plasticity and tendency to minimize the number of energy transformations ensure consistency of the structure. The main tasks in this regard include the temperature and ion composition stabilizing, the regeneration of the stroma, data mediums and

**59**

*Biomechanics as an Element of the Motion Clinimetry System*

subtle molecular response to environmental stimuli.

**8. Modulation of the body motor parameters**

sports [88, 89]; and accidents.

utilization [90].

enzyme systems. In emergency states, the majority of chemical reactions in a living cell can occur at some distance from the optimum; however, the thermodynamic efficiency of a given transformation decreases in such case. The amount of energy obtained per a substrate mass unit diminishes, with a significant increase in the production of waste products. On the organ level, such a situation is identified with the developing disease process, in which a large role is played by the control disorders. A prolonged dysfunction affects the structure of the individual cells or their groups, leading to the reduction in their functional reserves and slowing their recovery, with a steady increase in the rate of the waste substance accumulation. The conjunction of these processes causes the system to reach the control point, trespassing which starts an irreversible process of the apoptosis. Persistent regulatory metabolic disorders can lead to permanent organic changes. Information from skin, muscle, tendon, and visceral receptors regarding the influence of the environment on the body, through the ascending paths, reaches the central nervous system, where it is recorded and analyzed. Depending on the final response to the stimulus at the level of the core, hypothalamus, or cortex, the body reacts with an autonomic reflex or conscious action. In the case of conscious actions, it can be a deliberate motor reaction, while an example of a reflex follow-up reaction is the accompanying movement of the tension of other skeletal muscles, ensuring the body's balance. Autonomic reflexes occur without the participation of consciousness, enabling, for example, automatic glycemic control, symmetry of blood distribution in micro- and macrocirculation, or regulation of endocrine gland secretion. This often causes the

There are many factors affecting the precision of the targeted and follow-up movements such as fatigue [84]; emotional conditions [85]; mental disorders, such as depression and schizophrenia [86]; postictal conditions [87]; extreme

Pain modifies the body movements in a variety of ways. Being an alarm reaction, in the first place, it leads to the reduction in the range of motion along pain-causing, collision trajectories, compensating them by the development of nonphysiological or paraphysiological paths, known as the asymmetric profile of dysfunction. Unilateral reduction in the amplitude of motion, along with compensatory increment in another, usually symmetrical area of the body, disturbs smooth, alternating symmetry of muscle work. Virtually every clinical problem that is directly or indirectly associated with the gait function affects the symmetry of foot, knee, and spine load and consequently the degree of their functional and adaptive reserve

The consolidation of the asymmetrical compensatory movement pattern leads over time to more or less advanced anatomical modifications, including muscle, joint, tendon, and ligament remodeling and even remodeling of the bone structure. These changes are noticeable not only due to the use of advanced imaging techniques, such as CT, MRI, and PET, but also on classic radiophotography images. The problem is only that in the medical community, because attention is still not being paid to looking for the causes of apparent asymmetries. A good example would be an X-ray of both femurs, one of which has a clearly thinner cortical layer. Radiological descriptions rarely suggest that one of the patient's legs is shorter and that most of the body weight (>50%) is transferred to it, which results in remodeling and thickening of the cortical bone layer [91]. The evolutionally accumulating experiences of species that, apart from the rigid behavior of the hypothalamus in

*DOI: http://dx.doi.org/10.5772/intechopen.92757*

*Biomechanics as an Element of the Motion Clinimetry System DOI: http://dx.doi.org/10.5772/intechopen.92757*

*Recent Advances in Biomechanics*

could threaten the balance of the whole body. This procedure forces involuntary, follow-up reflexes from the extrapyramidal system, which modulate skeletal muscle tone in different parts of the body, allowing to maintain the balance and constant direction in relation to the gravity vector. A living organism, in contrast to a comparable (in terms of size) and stable (in given circumstances) crystal structure, is a visco-elastic body that changes its characteristics locally, rather than in a way that would be optimally adapted to the forces acting from the outside. Every kinematic situation, which can be described using a simple marker geometry, has a qualitatively different way of linking active information conveyors (nerves), energy converters (muscles), and the blood distribution, which conditions the efficiency of locally intensified metabolism. Local blood distribution profile is connected with ion concentration changes, which by means of the changing tissue resistance, impedance, and magnetic induction influence the sensitivity of the skin sensors. These parameters can be registered using electrodiagnostic methods, such as ECG, EEG, EMG, ENG, and EEA. It can therefore be assumed that each of the organ pairs existing in a living body, despite their high degree of structural and functional autonomy, functions in an information-coupled way through mirror elements of the nervous system and also in a hormone-distribution-coupled way, realized through the vascular system. In order to obtain a complete dysfunction image, it is therefore not sufficient to merely evidence asymmetries in the goniometric tests, as neurogenic, vascular, and immunological causative factors should also be taken into

One of the control strategies aimed at maintaining the general symmetry plan within a pair of organs is their individual endeavor to develop their own existence, which manifests itself in the competition for access to the distribution of nutrients and a tendency for constant reconstruction and redevelopment. In case of damage in one part of an organ pair in the nervous system, at least two basic survival strategies are launched, the first of which consists in intensification of the vascular perfusion and activation of neuronal paracrine secretion, conducive to hypertrophy and hyperplasia of cells in the damaged organ. The second strategy consists in increasing the metabolic efficiency of an intact organ, increasing its contribution to maintaining steadiness of parametric balance at the central level. Organ reflexes for the first strategy are located at the level of the lowest spinal cord integrators and for the second at the level of high spinal cord integrators and hypothalamus [82, 83]. The algorithms shaping motor and metabolic coordination in a living organism

are interactive, held under the form of the convergent or opposing oscillations around certain equilibrium points. The extent of this oscillation, being the body's response to the changing environmental stimuli, depends on regulatory efficiency on kinematic, computer, and metabolic level of the system. A young organism, not having many coordination engrams, reacts cautiously, using a large number of oscillations with high parametric amplitudes, trying to optimize to the equilibrium points. A mature organism, having a shaped profile of movement strategies, adapts its behavior to the situation a lot faster and moreover in a balanced and

Cellular homeostasis manifests itself by an individual cell's ability to develop functional states with parameters that pose no threat to the system itself. Its higher level—the tissue homeostasis—is a feedback of many metabolic oscillators, whose plasticity and tendency to minimize the number of energy transformations ensure consistency of the structure. The main tasks in this regard include the temperature and ion composition stabilizing, the regeneration of the stroma, data mediums and

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elegant manner.

account.

**7.3 Control strategy**

enzyme systems. In emergency states, the majority of chemical reactions in a living cell can occur at some distance from the optimum; however, the thermodynamic efficiency of a given transformation decreases in such case. The amount of energy obtained per a substrate mass unit diminishes, with a significant increase in the production of waste products. On the organ level, such a situation is identified with the developing disease process, in which a large role is played by the control disorders.

A prolonged dysfunction affects the structure of the individual cells or their groups, leading to the reduction in their functional reserves and slowing their recovery, with a steady increase in the rate of the waste substance accumulation. The conjunction of these processes causes the system to reach the control point, trespassing which starts an irreversible process of the apoptosis. Persistent regulatory metabolic disorders can lead to permanent organic changes. Information from skin, muscle, tendon, and visceral receptors regarding the influence of the environment on the body, through the ascending paths, reaches the central nervous system, where it is recorded and analyzed. Depending on the final response to the stimulus at the level of the core, hypothalamus, or cortex, the body reacts with an autonomic reflex or conscious action. In the case of conscious actions, it can be a deliberate motor reaction, while an example of a reflex follow-up reaction is the accompanying movement of the tension of other skeletal muscles, ensuring the body's balance. Autonomic reflexes occur without the participation of consciousness, enabling, for example, automatic glycemic control, symmetry of blood distribution in micro- and macrocirculation, or regulation of endocrine gland secretion. This often causes the subtle molecular response to environmental stimuli.

#### **8. Modulation of the body motor parameters**

There are many factors affecting the precision of the targeted and follow-up movements such as fatigue [84]; emotional conditions [85]; mental disorders, such as depression and schizophrenia [86]; postictal conditions [87]; extreme sports [88, 89]; and accidents.

Pain modifies the body movements in a variety of ways. Being an alarm reaction, in the first place, it leads to the reduction in the range of motion along pain-causing, collision trajectories, compensating them by the development of nonphysiological or paraphysiological paths, known as the asymmetric profile of dysfunction. Unilateral reduction in the amplitude of motion, along with compensatory increment in another, usually symmetrical area of the body, disturbs smooth, alternating symmetry of muscle work. Virtually every clinical problem that is directly or indirectly associated with the gait function affects the symmetry of foot, knee, and spine load and consequently the degree of their functional and adaptive reserve utilization [90].

The consolidation of the asymmetrical compensatory movement pattern leads over time to more or less advanced anatomical modifications, including muscle, joint, tendon, and ligament remodeling and even remodeling of the bone structure. These changes are noticeable not only due to the use of advanced imaging techniques, such as CT, MRI, and PET, but also on classic radiophotography images. The problem is only that in the medical community, because attention is still not being paid to looking for the causes of apparent asymmetries. A good example would be an X-ray of both femurs, one of which has a clearly thinner cortical layer. Radiological descriptions rarely suggest that one of the patient's legs is shorter and that most of the body weight (>50%) is transferred to it, which results in remodeling and thickening of the cortical bone layer [91]. The evolutionally accumulating experiences of species that, apart from the rigid behavior of the hypothalamus in

the cerebrum created the seeds of abstract thinking, tend to quickly expand the strategy of survival in the environment by joining simple unconditional reflexes complex sequences of behavior aimed at classifying the environment into neutral, health-promoting areas (vegetation, water reservoirs, mineral deposits) and clearly hazardous (e.g., deposits of toxic substances).

#### **8.1 Elements of the movement metrology**

The symmetry of the structure and function of the basic elements of the human body remains in a close cause-and-effect relationship with the symmetry of the structure of the nervous system, treated as a control system, as well as the vascular system, which is in fact a supply and control system for the cellular stroma. Therefore, it can be assumed that each of the organ pairs existing in the living organism, despite the high level of structural separation, functions in an information-coupled manner by means of mirror elements of the nervous system, as well as in hormonal-distribution couplings implemented through the vascular system. The balance of the neural network conducted in subsequent integrators of the spinal cord and hypothalamus, in terms of controlling the distribution of signal and nutrients, including the mechanical and energetic loading of pairs of twin organs, allows their maintenance in a state of functional and anatomical symmetry.

The macroscopic effects of maintained symmetries (especially in the geometrical range) currently belong to the basic criteria for assessing the condition of the musculoskeletal system. However, using the bioengineering assessment of the disease, which occurs with one limb dysfunction, it can be presented as asymmetries of individual parameters or parametric sets, not only regarding the location of markers of body movement in 3D space but also muscle strength, blood supply, resistance, temperature, and skin sensitivity to stimuli, while the numerical determinant of these asymmetries decreases from unity to 0, as the dysfunction increases in the course of the disease and increases again (to values close to unity), in a manner proportional to the disappearance of the symptoms of the disease [92, 93].

In this context, it is worth paying attention to the need for a reliable, parametric and quantitative estimation (that corresponds with the degree of biomechanical dysfunction of the musculoskeletal system) of a greater number of internal body parameters, whose mutual relationships shape the causative dimension of the noticeable biomechanical asymmetries, as well as the disease-related feelings of the patient. It is worth to note that it is difficult to talk about a proper estimation of the current state, prognosis, and treatment effects, without a reliable estimation of the quantitative parameter. Therefore, methods for objective monitoring of disease parameters are actively searched for. Great importance is attached to diagnostic imaging, pathology, and electrodiagnostics. The criterion systems existing in modern medicine give high sensitivity and specificity of qualitative diagnoses, in particular for diseases with a well-recognized etiology and mechanisms of action. An experienced doctor examining a patient is able to see in his body many deviations, such as compensatory movement profile asymmetries, static kinetic reflex disturbances in the Romberg test, temperature and humidity asymmetry of limbs, difference in skin sensitivity to pain and touch, and asymmetry of limb mobility and reflexes; however, he has a difficulty in parametric and numerical estimation of the characteristics of his observations. Estimated methods still exist in the practically used scope of locomotor system assessment, based on interactive, subjective relations between the patient and the doctor, such as the older Lovett scale, visual analog scale (VAS), or newer quality of life scales [94, 95].

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even of the qualitative criteria [61].

*Biomechanics as an Element of the Motion Clinimetry System*

The metrological dimension of daily medical examinations of the musculoskeletal system is usually limited to the use of simple measurement techniques and tools, due to the difficult access to expensive, advanced measuring technology. In addition, although there are many sites with advanced quadroscopic and strain gauges for assessing and recording biomechanical parameters, their presentation and data

The first element of this procedure, an interview, organizes knowledge on the subjective symptoms of the patient. The study design is layered, because it begins with a general health assessment, and delves into the area of details that are specific for certain organs, so it is relatively easy to reduce it to a survey test, allowing for an approximate quantitative assessment. The quality of life rating scales, anatomicalfunctional syndrome assessment scales, and pain assessment scales have gained in

3.The general condition of the patient, in particular the duration and severity of

4.The level of intelligence of the patient, which determines the clarity of the

5.Patient's current attitude, modifying expression towards aggravulation or

6.Existence of nonmedical intention (desire to obtain compensation or disability

The doctor's education, clinical internship, and experience as well as his condition on the day of the examination determine whether the collected information

The physical examination is an assessment of the patient's state of health with the use of the telereceptors (eyesight, hearing, smell) and extroceptors (touch, heat, cold, movement) in palpation. The next stage of the study is the use of minimally invasive stimulations in the form of tactile and tactile stimuli, provocative tests, or simple measurement tools. Subsequently, tests are carried out using a goniometer, plurimeter, plumb line, and linear bearing, which allow simple numerical approximations, unfortunately often unrepeatable, due to the fact that every physician introduces some alterations (based on his/her own experience) into the measurement standards. In practice, it translates into introducing one's own interpretations or minor methodological mistakes, specific for one's habits referring to measurement position and the method of the measurement tool's application. These phenomena, provided that patients are examined by the same physician, generate a uniform and distinctive profile of system errors that are fairly easy to eliminate, but when these patients deal with other doctors, they are confronted with a different interpretation profile of the measurement principles (system errors). The overlapping of different approaches to accomplish the same measurement task often leads to the interpretation differences, not only in terms of quantitative assessments but

will be used as an inspiration for a series of diagnostic associations.

collection systems are usually incompatible on an inter-center scale.

importance here. The credibility of this information depends on:

1.The level of intelligence and education of the patient

2.The specifics of a physician's contact with the patient

*DOI: http://dx.doi.org/10.5772/intechopen.92757*

**9. Medical examination**

the disease

message

benefits)

dissimulation
