@article{FoerstlSuessEnglertetal., author = {F{\"o}rstl, Nikolas and S{\"u}ß, Franz and Englert, Carsten and Dendorfer, Sebastian}, title = {Design of a reverse shoulder implant to measure shoulder stiffness during implant component positioning}, series = {Medical Engineering \& Physics}, volume = {121}, journal = {Medical Engineering \& Physics}, edition = {Journal Pre-proof}, publisher = {Elsevier}, doi = {10.1016/j.medengphy.2023.104059}, pages = {22}, abstract = {To avoid dislocation of the shoulder joint after reverse total shoulder arthroplasty, it is important to achieve sufficient shoulder stability when placing the implant components during surgery. One parameter for assessing shoulder stability can be shoulder stiffness. The aim of this research was to develop a temporary reverse shoulder implant prototype that would allow intraoperative measurement of shoulder stiffness while varying the position of the implant components. Joint angle and torque measurement techniques were developed to determine shoulder stiffness. Hall sensors were used to measure the joint angles by converting the magnetic flux densities into angles. The accuracy of the joint angle measurements was tested using a test bench. Torques were determined by using thin-film pressure sensors. Various mechanical mechanisms for variable positioning of the implant components were integrated into the prototype. The results of the joint angle measurements showed measurement errors of less than 5° in a deflection range of ±15° adduction/abduction combined with ±45° flexion/extension. The proposed design provides a first approach for intra-operative assessment of shoulder stiffness. The findings can be used as a technological basis for further developments.}, language = {en} } @article{PfeiferMuellerPrantletal., author = {Pfeifer, Christian and M{\"u}ller, Michael and Prantl, Lukas and Berner, Arne and Dendorfer, Sebastian and Englert, Carsten}, title = {Cartilage labelling for mechanical testing in T-peel configuration}, series = {International Orthopaedics}, volume = {36}, journal = {International Orthopaedics}, number = {7}, publisher = {Springer}, doi = {10.1007/s00264-011-1468-3}, pages = {1493 -- 1499}, abstract = {PURPOSE: The purpose of this study was to find a suitable method of labelling cartilage samples for the measurement of distraction distances in biomechanical testing. METHODS: Samples of bovine cartilage were labelled using five different methods: hydroquinone and silver nitrate (AgNO3), potassium permanganate (KMnO4) with sodium thiosulphate (Na2S2O3), India ink, heat, and laser energy. After the labelling, we analysed the cartilage samples with regard to cytotoxity by histochemical staining with ethidiumbromide homodimer (EthD-1) and calcein AM. Furthermore, we tested cartilages labelled with India ink and heat in a T-peel test configuration to analyse possible changes in the mechanical behaviour between marked and unlabelled samples. RESULTS: Only the labelling methods with Indian ink or a heated needle showed acceptable results in the cytotoxity test with regard to labelling persistence, accuracy, and the influence on consistency and viability of the chondrocytes. In the biomechanical T-peel configuration, heat-labelled samples collapsed significantly earlier than unlabelled samples. CONCLUSION: Labelling bovine cartilage samples with Indian ink in biomechanical testing is a reliable, accurate, inexpensive, and easy-to-perform method. This labelling method influenced neither the biomechanical behaviour nor the viability of the tissue compared to untreated bovine cartilage.}, subject = {Knorpel}, language = {en} } @article{FoerstlAdlerSuessetal., author = {F{\"o}rstl, Nikolas and Adler, Ina and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Technologies for Evaluation of Pelvic Floor Functionality: A Systematic Review}, series = {Sensors}, volume = {24}, journal = {Sensors}, number = {12}, publisher = {MDPI}, doi = {10.3390/s24124001}, abstract = {Pelvic floor dysfunction is a common problem in women and has a negative impact on their quality of life. The aim of this review was to provide a general overview of the current state of technology used to assess pelvic floor functionality. It also provides literature research of the physiological and anatomical factors that correlate with pelvic floor health. This systematic review was conducted according to the PRISMA guidelines. The PubMed, ScienceDirect, Cochrane Library, and IEEE databases were searched for publications on sensor technology for the assessment of pelvic floor functionality. Anatomical and physiological parameters were identified through a manual search. In the systematic review, 114 publications were included. Twelve different sensor technologies were identified. Information on the obtained parameters, sensor position, test activities, and subject characteristics was prepared in tabular form from each publication. A total of 16 anatomical and physiological parameters influencing pelvic floor health were identified in 17 published studies and ranked for their statistical significance. Taken together, this review could serve as a basis for the development of novel sensors which could allow for quantifiable prevention and diagnosis, as well as particularized documentation of rehabilitation processes related to pelvic floor dysfunctions.}, language = {en} } @article{MelznerIsmailRušavyetal., author = {Melzner, Maximilian and Ismail, Khaled M. and Rušavy, Zdenek and Kališ, Vladim{\´i}r and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal lower back load of accoucheurs during childbirth - A pilot and feasibility study}, series = {European Journal of Obstetrics \& Gynecology and Reproductive Biology}, journal = {European Journal of Obstetrics \& Gynecology and Reproductive Biology}, number = {264}, publisher = {Elsevier}, doi = {10.1016/j.ejogrb.2021.07.042}, pages = {306 -- 313}, abstract = {Introduction: Back problems represent one of the leading causes of accouchers' work-related musculoskeletal morbidities. The correct execution of birth-related maneuvers including manual perineal protection is crucial not only for the mother and child but also for obstetricians and midwives to reduce any strain on their musculoskeletal system. Therefore, the overall aim of this study was to test the feasibility of determining the effect of different accouchers' postures (standing and kneeling) on their musculoskeletal system. Methods: The biomechanical analysis is based on musculoskeletal simulations that included motion recordings of real deliveries as well as deliveries conducted on a birthing simulator. These simulations were then used to determine individual joints' loads. Results: In the kneeling posture, both a low intra-operator variability and a lower average maximum load of the lower back was observed. For the standing position the spine load was reduced by pivoting the elbow on the accouchers' thigh, which in turn was associated with a significantly greater load on the shoulder joint. Conclusion: The study demonstrated the feasibility of our technique to assess joints loads. It also provided initial data indicating that a posture that reduces spinal flexion and tilt, achieved in this study by the kneeling, can significantly reduce the strain on the practitioner's musculoskeletal system.}, language = {en} } @article{RusavyCechovaDendorferetal., author = {Rusavy, Zdenek and Cechova, Hana and Dendorfer, Sebastian and Kalis, Vladimir and Ismail, Khaled M.}, title = {Is the Finnish grip tight enough? A manometric study of two manual perineal protection techniques}, series = {Acta Obstetricia et Gynecologica Scandinavica}, volume = {104}, journal = {Acta Obstetricia et Gynecologica Scandinavica}, number = {2}, publisher = {Wiley}, doi = {10.1111/aogs.15033}, pages = {423 -- 425}, language = {en} } @article{MoragKieningerEissnertetal., author = {Morag, Sarah and Kieninger, Martin and Eissnert, Christoph and Auer, Simon and Dendorfer, Sebastian and Popp, Daniel and Hoffmann, Johannes and Kieninger, B{\"a}rbel}, title = {Comparison of different techniques for prehospital cervical spine immobilization: Biomechanical measurements with a wireless motion capture system}, series = {PLOS ONE}, volume = {18}, journal = {PLOS ONE}, number = {11}, publisher = {PLOS}, address = {San Francisco, California}, doi = {10.1371/journal.pone.0292300}, pages = {1 -- 14}, language = {en} } @article{HoenickaLehleJacobsetal., author = {Hoenicka, Markus and Lehle, Karla and Jacobs, V. R. and Dendorfer, Sebastian and Kostorz, A. and Schmid, F. X. and Birnbaum, D. E.}, title = {Mechanical and seeding properties of human umbilical vein - a potential scaffold for a tissue-engineered vessel graft}, series = {The Thoracic and Cardiovascular Surgeon}, volume = {55}, journal = {The Thoracic and Cardiovascular Surgeon}, number = {S 1}, publisher = {Thieme}, doi = {10.1055/s-2007-967592}, pages = {P_37}, abstract = {Objectives: The mechanical properties and seeding with endothelial cells were investigated in fresh and cryopreserved human umbilical vein. Methods: Human umbilical veins (HUV) were frozen in Euro-Collins/1M DMSO at -1°C/min and stored in liquid nitrogen. Stress-strain relationships of fresh and thawed veins were determined in an uniaxial tension-testing rig. HUV endothelial cells (HUVEC) were seeded onto denuded HUV under static conditions and grown for 3d. Luminal surfaces were analyzed by scanning electron microscopy. Calcein-stained cells were seeded hyperconfluently to determine the cell retention capacity of fresh and cryopreserved veins. Results: The stress-strain relationships of HUV followed a biphasic pattern typical for natural vessels. Neither the failure stress (2.71±0.36 vs. 3.25±0.97 N, n=3) nor the displacement required to achieve failure (9.73±0.9 vs. 7.43±2.07mm, n=3) were altered by cryopreservation. The burst pressure was estimated as approx. 1000mm Hg within the limitations of the uniaxial model. HUVEC seeded onto denuded HUV formed patches (at 9E3 cells per cm2) or an almost confluent endothelium (at 3E4 cells per cm2) within three days. The capacity to retain seeded HUVEC of denuded HUV was not altered by cryopreservation (1.15±0.08E5 vs. 1.26±0.14E5 cells per cm2, n=6). Conclusions: The burst pressure of HUV seems to be sufficiently high for the human arterial circulation and is not altered by cryopreservation. HUVEC can establish a confluent endothelium on denuded HUV. Therefore HUV appears to be a suitable storable scaffold for vascular tissue engineering.}, subject = {Nabelvene}, language = {en} } @article{LazarevRiabokonHalleretal., author = {Lazarev, Igor A. and Riabokon, P. V. and Haller, M. and Dendorfer, Sebastian}, title = {Effect of the Displacement of Calcaneal Bone Peripheral Fragment in its Fracture on the Function of the Three-Headed Calf Muscle}, series = {TRAUMA}, volume = {16}, journal = {TRAUMA}, number = {2}, publisher = {Zaslavsky}, doi = {10.22141/1608-1706.2.16.2015.80247}, pages = {20 -- 24}, abstract = {In the structure of musculoskeletal injuries, calcaneal fractures account for up to 4 \% of all skeletal fractures and up to 60 \% of hindfoot fractures. The effect of the displacement of the peripheral fragment of the calcaneus on the calf muscles's reaction forces at the time of the adoption of the simplified squatting position was investigated by modeling in AnyBody Modeling System 6.0 software. M.gastrocnemius (lateralis et medialis) in the initial phase of motion in all variants of the peripheral fragment displacement did not develop sufficient muscular effort in comparison to the intact calcaneus. M.soleus medialis et lateralis showed significant increase in muscle activity rates in the initial phase of motion (41.87 ± 1.90 H and 52.07 ± 2.10 H) before reaching its maximum values, as compared with those of the intact calcaneus. In the final phase of the movement, upon muscle reaches its maximum length, muscular strength indicators of the m.soleus returned to their original values or were significantly below them. The decline in muscle strength was due to shortening of the moment arm or muscle excursion in case of convergence of muscle attachment points. When the peripheral fragment is displaced, due to putting down the heel to the surface of the support in terms of anatomical muscle lengthening, it takes extra effort to achieve rest length and its maximum power. In all types of the displacement of the peripheral fragment, the function of three-headed calf muscle is disturbed with involvement of additional muscular effort and energy expenditure. This fact should motivate the surgeon on the need for accurate repositioning of bone fragments in calcaneal fractures with the displacement of the peripheral fragment.}, language = {en} } @article{LazarevRyabokonHalleretal., author = {Lazarev, Igor A. and Ryabokon, P.V. and Haller, M. and Dendorfer, Sebastian}, title = {Effect of the fractured calcaneus's peripheral fragment displacement on the triceps surae function}, series = {ЖУРНАЛ «ТРАВМА» Ukrainian Trauma Journal}, volume = {2, TOM 16}, journal = {ЖУРНАЛ «ТРАВМА» Ukrainian Trauma Journal}, language = {en} } @article{DendorferMaierHammer, author = {Dendorfer, Sebastian and Maier, Hans J{\"u}rgen and Hammer, Joachim}, title = {Fatigue damage in cancellous bone: an experimental approach from continuum to micro scale}, series = {Journal of the Mechanical Behavior of Biomedical Materials}, volume = {2}, journal = {Journal of the Mechanical Behavior of Biomedical Materials}, number = {1}, doi = {10.1016/j.jmbbm.2008.03.003}, pages = {113 -- 119}, abstract = {Repeated loadings may cause fatigue fractures in bony structures. Even if these failure types are known, data for trabecular bone exposed to cyclic loading are still insufficient as the majority of fatigue analyses on bone concentrate on cortical structures. Despite its highly anisotropic and inhomogeneous structure, trabecular bone is treated with continuum approaches in fatigue analyses. The underlying deformation and damage mechanism within trabecular specimens are not yet sufficiently investigated. In the present study different types of trabecular bone were loaded in monotonic and cyclic compression. In addition to the measurement of integral specimen deformations, optical deformation analysis was employed in order to obtain strain distributions at different scale levels, from the specimens' surface to the trabeculae level. These measurements allowed for the possibility of linking the macroscopic and microscopic mechanical behaviour of cancellous bone. Deformations were found to be highly inhomogeneous across the specimen. Furthermore strains were found to already localise at very low load levels and after few load cycles. Microcracks in individual trabeculae were induced in the very early stage of cyclic testing. The results provide evidence of the capability of the method to supply essential data on the failure behaviour of individual trabeculae in future studies.}, subject = {Knochen}, language = {en} } @article{HoelscherWeberLazarevetal., author = {H{\"o}lscher, Thomas and Weber, Tim A. and Lazarev, Igor A. and Englert, Carsten and Dendorfer, Sebastian}, title = {The influence of rotator cuff tears on glenohumeral stability during abduction tasks}, series = {Journal of Orthopaedic Research}, volume = {34}, journal = {Journal of Orthopaedic Research}, number = {9}, doi = {10.1002/jor.23161}, pages = {1628 -- 1635}, abstract = {One of the main goals in reconstructing rotator cuff tears is the restoration of glenohumeral joint stability, which is subsequently of utmost importance in order to prevent degenerative damage such as superior labral anterior posterior (SLAP) lesion, arthrosis, and malfunction. The goal of the current study was to facilitate musculoskeletal models in order to estimate glenohumeral instability introduced by muscle weakness due to cuff lesions. Inverse dynamics simulations were used to compute joint reaction forces for several static abduction tasks with different muscle weakness. Results were compared with the existing literature in order to ensure the model validity. Further arm positions taken from activities of daily living, requiring the rotator cuff muscles were modeled and their contribution to joint kinetics computed. Weakness of the superior rotator cuff muscles (supraspinatus; infraspinatus) leads to a deviation of the joint reaction force to the cranial dorsal rim of the glenoid. Massive rotator cuff defects showed higher potential for glenohumeral instability in contrast to single muscle ruptures. The teres minor muscle seems to substitute lost joint torque during several simulated muscle tears to maintain joint stability. Joint instability increases with cuff tear size. Weakness of the upper part of the rotator cuff leads to a joint reaction force closer to the upper glenoid rim. This indicates the comorbidity of cuff tears with SLAP lesions. The teres minor is crucial for maintaining joint stability in case of massive cuff defects and should be uprated in clinical decision-making.}, subject = {Rotatorenmanschettenriss}, language = {en} } @article{EnglertAngeleFierlbecketal., author = {Englert, Carsten and Angele, Peter and Fierlbeck, J. and Dendorfer, Sebastian and Schubert, T. and M{\"u}ller, R. and Lienhard, S. and Zellner, Johannes and Nerlich, Michael and Neumann, Carsten}, title = {Conductive bone substitute material with variable antibiotic delivery}, series = {Der Unfallchirurg}, volume = {110}, journal = {Der Unfallchirurg}, number = {5}, publisher = {Springer}, doi = {10.1007/s00113-007-1229-3}, pages = {408 -- 413}, abstract = {A new bone substitute, consisting of hydroxylapatite and calcium sulphate, was prepared in two formulations and analysed for its mechanical strength and antibiotic elution.The bone substitute PerOssal has osteoconductive and degradable properties. The material has a built-in capillary structure, which results in an immediate fluid uptake. Antibiotics absorbed to the bone substitute resulted in a prolonged release rate. Mechanical strength was investigated by an unconfined compression test up to failure under both wet and dry conditions for both formulations of the bone substitute. Antibiotic release was analysed microbiologically for two antibiotics, vancomycin and gentamicin, over an elution period of 10 days using the agar diffusion method.The drug release analysis resulted in a prolonged release rate of both antibiotics over 10 days. In vitro the amount of gentamicin and vancomycin eluted at day 10. From one pellet still exceeded the minimal inhibitory concentration of most aetiologically important pathogens. Formulation two of the present bone substitute is significantly harder in both wet and dry conditions when compared to formulation one. Both formulations lose strength in the wet condition relative to their performance in the dry condition. However, formulation two is as hard under wet conditions as formulation one is when dry.PerOssal is a suitable new degradable osteoconductive bone substitute that can be loaded with antibiotic solutions, which are released in effective doses over 10 days. The mechanical strength of PerOssal is sufficient to support cancellous bone defects in non-weight-bearing areas or in combination with osteosynthesis.}, subject = {Knochenersatz}, language = {en} } @article{SchaefferHerrmannSchratzenstalleretal., author = {Schaeffer, Leon and Herrmann, David and Schratzenstaller, Thomas and Dendorfer, Sebastian and B{\"o}hm, Valter}, title = {Theoretical considerations on stiffness characteristics of a 3-dimensional tensegrity joint model for the use in dynamic hand orthoses}, series = {Journal of Medical Robotics Research}, journal = {Journal of Medical Robotics Research}, publisher = {World Scientific}, doi = {10.1142/S2424905X25400069}, language = {en} } @article{BarthelSuessDendorfer, author = {Barthel, Mareike and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Application of a transformer encoder for the prediction of intra-abdominal pressure}, series = {Computer Methods in Biomechanics and Biomedical Engineering}, journal = {Computer Methods in Biomechanics and Biomedical Engineering}, publisher = {Taylor \& Francis}, doi = {10.1080/10255842.2025.2586143}, pages = {11}, abstract = {Intra-abdominal pressure is a significant physiological parameter influencing spinal stability and pelvic floor health. This study investigates the potential of a transformer encoder model to predict IAP using motion capture data and musculoskeletal modeling. Data from 211 subjects performing walking, fast walking, and running were used to train a transformer encoder. The model showed promising results with an overall Mean Absolute Percentage Error of 13.5\% and a Pearson correlation coefficient of 0.85. Predictions for fast walking and running proved to be more challenging compared to walking, which was attributed to the greater variability and complexity of faster movements.}, language = {en} } @article{TroesterEcksteinKenneletal., author = {Tr{\"o}ster, Mark and Eckstein, Simon and Kennel, Paula and Kopp, Verna and Benkiser, Alina and Bihlmeier, Felicitas and Daub, Urban and Maufroy, Christophe and Dendorfer, Sebastian and Fritzsche, Lars and Schneider, Urs and Bauernhasl, Thomas}, title = {Person-specific evaluation method for occupational exoskeletons - Biomechanical body heat map}, series = {Applied Ergonomics}, volume = {132}, journal = {Applied Ergonomics}, publisher = {Elsevier}, doi = {10.1016/j.apergo.2025.104671}, pages = {30}, abstract = {Human-centred and ergonomic work design is one of the most important drivers for increasing the competitiveness of the European Union. As a flexible, person-specific occupational measure, exoskeletons promise great potential for effectively reducing individual ergonomic stress. Digital human models can provide important insights and offer great potential for systematising the effect and targeted use of exoskeletons, supporting their effective implementation in practice. In this article, digital human models are applied on two levels. Firstly, a realistic industrial logistics scenario in which boxes had to be relocated is designed with the help of a digital human model for workplace and process planning and secondly, a new biomechanical evaluation methodology to analyse intended and unintended effects on internal stress on the human body is demonstrated by applying musculoskeletal exoskeleton human models of four test subjects. Finally, the modelled biomechanical support tendencies of one exoskeleton are preliminary validated using EMG measurement data of the back muscles collected from the four male workers. The preliminary analysis of two back-support exoskeletons to demonstrate the new methodological approach confirms the expected, intended effects in the lower back and reveals unintended effects, such as e.g. changes in knee kinetics when applying a soft or hard-frame exoskeleton. Furthermore, the exemplary results to demonstrate the methodological approach expose notable differences between the test subjects, which underlines the relevance of person-specific evaluation and consideration of exoskeleton support. The preliminary validation shows a correlation between the modelled and the EMG-measured biomechanical exoskeleton support of the considered back muscles.}, language = {en} } @article{KrausKnipferJacobetal., author = {Kraus, Richard F. and Knipfer, Maximilian L. and Jacob, Matthias and Kieninger, Baerbel and Alikhani, Jasmine and Ghamsary, Parham Heydarzadeh and Reinker, Lukas and Adler, Ina and Dendorfer, Sebastian and Kieninger, Martin}, title = {Effectiveness and safety of techniques for cervical spine immobilization in mountain rescue}, series = {Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}, volume = {34}, journal = {Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}, publisher = {Springer}, doi = {10.1186/s13049-025-01530-z}, pages = {10}, abstract = {BACKGROUND Cervical spine injuries in alpine sports require immediate immobilization at the site of the accident to avoid possible secondary damage caused by transportation. Using special sensor technology, this study investigated whether a cervical spine orthosis (cervical collar, Stifneck collar (Laerdal Medical GmbH, Puchheim, Germany)) provides greater stability than a vacuum mattress alone. METHODS Using one male test person, we simulated transporting a patient with a spinal injury in steep alpine terrain. A wireless motion capture system (Xsens Technologies, Movella™ Inc., Henderson, USA) was used to record motion in three-dimensional space within a standardized environment. All tests were performed on a set course by the Bavarian Mountain Rescue Service. The test person lay on a mountain rescue stretcher and was immobilized with a vacuum mattress, either with or without a cervical orthosis. The axes of cervical spine movements were analyzed separately. RESULTS There were no significant differences between immobilization with and without a cervical orthosis with regard to lateral flexion (max. 3.7° compared to 3.0°) in the frontal plane and maximum excursion in flexion (max. 1.6° compared to 2.8°) or extension (max. -1.6° compared to -1.7°). There was significantly greater rotation movement around the craniocaudal axis without an orthosis (max. 2.4° compared to 1.3°). CONCLUSION During mountain rescues, the cervical spine can be immobilized without a rigid cervical spine orthosis. Future research should explore the fundamental benefits of cervical spine immobilization, while the findings of this work contribute to the safe care of patients by avoiding the disadvantages associated with rigid cervical orthoses.}, language = {en} } @article{KrausKnipferJacobetal., author = {Kraus, Richard and Knipfer, Maximilian and Jacob, Matthias and Kienninger, Baerbel and Alikhani, Jasmine and Ghamsary, Parham Heydarzadeh and Reinker, Lukas and Adler, Ina and Dendorfer, Sebastian and Kieninger, Martin}, title = {Effectiveness and safety of techniques for cervical spine immobilization in mountain rescue}, series = {Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}, volume = {34}, journal = {Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}, publisher = {Springer}, doi = {10.1186/s13049-025-01530-z}, pages = {10}, abstract = {Background Cervical spine injuries in alpine sports require immediate immobilization at the site of the accident to avoid possible secondary damage caused by transportation. Using special sensor technology, this study investigated whether a cervical spine orthosis (cervical collar, Stifneck collar (Laerdal Medical GmbH, Puchheim, Germany)) provides greater stability than a vacuum mattress alone. Methods Using one male test person, we simulated transporting a patient with a spinal injury in steep alpine terrain. A wireless motion capture system (Xsens Technologies, Movella™ Inc., Henderson, USA) was used to record motion in three-dimensional space within a standardized environment. All tests were performed on a set course by the Bavarian Mountain Rescue Service. The test person lay on a mountain rescue stretcher and was immobilized with a vacuum mattress, either with or without a cervical orthosis. The axes of cervical spine movements were analyzed separately. Results There were no significant differences between immobilization with and without a cervical orthosis with regard to lateral flexion (max. 3.7° compared to 3.0°) in the frontal plane and maximum excursion in flexion (max. 1.6° compared to 2.8°) or extension (max. -1.6° compared to -1.7°). There was significantly greater rotation movement around the craniocaudal axis without an orthosis (max. 2.4° compared to 1.3°). Conclusion During mountain rescues, the cervical spine can be immobilized without a rigid cervical spine orthosis. Future research should explore the fundamental benefits of cervical spine immobilization, while the findings of this work contribute to the safe care of patients by avoiding the disadvantages associated with rigid cervical orthoses.}, language = {en} }