Kriener Kyleigh, Sinclair Kate, Robison Grant, Lala Raushan, Finley Hayley, Richardson William Jase, Midwinter Mark J
School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia.
Ochsner Clinical School, 1401 Jefferson Hwy, Jefferson, LA 70121, USA.
Bioengineering (Basel). 2025 Jan 7;12(1):41. doi: 10.3390/bioengineering12010041.
The haptic fidelity of biomimetic materials used in the design of procedural task trainers is of growing interest to the medical community. Shore hardness has been proposed as a method for assessing tissue biomechanics and replicating the results as a way to increase the fidelity of biomimetics to tissues. However, there is limited research on the reliability of human tissue measurements using Shore scales. Using human tissues (internal carotid artery [ICA], internal jugular vein [IJV], vagus nerve [VN], sternocleidomastoid muscle [SCM], and overlying skin [skin]), this study evaluates (1) the inter-rater reliability of Shore hardness measurements, (2) examines the relationship between tissue thickness and hardness, and (3) investigates the impact of a measurement method (freehand vs. durometer stand). Preserved tissues, specifically a liver and components of the anterior triangle of the neck, were extracted from cadavers and measured by three independent raters using digital Shore durometers. Testing revealed that although Shore A demonstrated better inter-rater reliability compared to Shore OO, both scales exhibited poor-to-moderate reliability. ICC values for Shore A ranged from 0.21 to 0.80 and were statistically significant ( < 0.05) for all tissue types except the SCM. In contrast, Shore OO demonstrated poorer reliability, with ICC values ranging from 0.00 to 0.41. The ICC values were only significant for the ICA, IJV, and VN ( < 0.05). An inverse correlation between tissue thickness and hardness on the Shore A scale was found for all tissues and was significant ( < 0.05) for ICA, VN, and skin. There were mixed results for the correlation between tissue thickness and hardness on the Shore OO scale (-0.06-0.92), and only IJV had a statistically significant correlation ( < 0.05). Finally, the median hardness values on the Shore OO scale were significantly greater when measured using a durometer stand vs. freehand (Z = 4.78, < 0.05). In summary, when using appropriate standards and addressing the challenges of tissue thickness and variability in freehand measures, Shore hardness has the potential to be used by clinicians in the clinical setting and in the selection of biomimetic materials in the design of task trainers.
程序任务训练器设计中使用的仿生材料的触觉逼真度越来越受到医学界的关注。肖氏硬度已被提议作为一种评估组织生物力学并复制结果的方法，以此来提高仿生材料对组织的逼真度。然而，关于使用肖氏硬度计测量人体组织的可靠性的研究有限。本研究使用人体组织（颈内动脉[ICA]、颈内静脉[IJV]、迷走神经[VN]、胸锁乳突肌[SCM]和覆盖皮肤[skin]）评估：（1）肖氏硬度测量的评分者间可靠性；（2）检查组织厚度与硬度之间的关系；（3）研究测量方法（徒手测量与硬度计支架测量）的影响。从尸体中提取保存的组织，特别是肝脏和颈部前三角区的组织成分，由三名独立的评分者使用数字肖氏硬度计进行测量。测试表明，虽然与肖氏OO相比，肖氏A表现出更好的评分者间可靠性，但两种硬度计的可靠性都较差到中等。肖氏A的组内相关系数（ICC）值范围为0.21至0.80，除SCM外，所有组织类型的ICC值均具有统计学意义（<0.05）。相比之下，肖氏OO的可靠性较差，ICC值范围为0.00至0.41。ICC值仅在ICA、IJV和VN中具有统计学意义（<0.05）。在肖氏A硬度计上，所有组织的组织厚度与硬度之间均呈负相关，ICA、VN和皮肤的相关性具有统计学意义（<0.05）。肖氏OO硬度计上组织厚度与硬度之间的相关性结果不一（-0.06至0.92），只有IJV具有统计学意义（<0.05）。最后，使用硬度计支架测量时，肖氏OO硬度计的中位硬度值显著高于徒手测量（Z = 4.78，<0.05）。总之，在使用适当标准并解决组织厚度和徒手测量变异性的挑战时，肖氏硬度有可能被临床医生用于临床环境以及在任务训练器设计中选择仿生材料。
