Integrative biomechanics: a paradigm for clinical applications of fundamental mechanics.

Integrative biomechanics uses biomechanics knowledge and methods at multiple scales and among biological entities to address fundamental and clinical problems at the tissue and organ level. Owing to the large ranges of scale involved, integrative biomechanics is intrinsically multidisciplinary, extending from molecular biophysics to contemporary engineering descriptions of kinematics and bulk constitutive properties. Much of this integration is accomplished through multiscale models of the interactions of interest. Applications can range from the development of new biological knowledge to the creation of new technologies for clinical application. In this white paper, the historical background of, and the rationale behind, integrative biomechanics are reviewed, followed by a sampling of clinical advances that were developed using the integrative approach. Refinements of many of these advances are still needed, and unsolved problems remain, in genomic applications, developing improved interventional procedures and protocols, and personalized medicine. Challenges to achieve these goals include the need for better models and the acquisition and organization of the data needed to parameterize, validate and apply them. These challenges will be overcome, because the advances in characterizing disease risk, personalization of care, and therapeutics that will follow, demand that we continue to move forward in this exciting field.