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Viehöfer AF, Gerber C, Favre P, Bachmann E, Snedeker JG. A larger critical shoulder angle requires more rotator cuff activity to preserve joint stability. J Orthop Res 2016; 34:961-8. [PMID: 26572231 DOI: 10.1002/jor.23104] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 11/03/2015] [Indexed: 02/04/2023]
Abstract
Shoulders with rotator cuff tears (RCT) tears are associated with significantly larger critical shoulder angles (CSA) (RCT CSA = 38.2°) than shoulders without RCT (CSA = 32.9°). We hypothesized that larger CSAs increase the ratio of glenohumeral joint shear to joint compression forces, requiring substantially increased compensatory supraspinatus loads to stabilize the arm in abduction. A previously established three dimensional (3D) finite element (FE) model was used. Two acromion shapes mimicked the mean CSA of 38.2° found in patients with RCT and that of a normal CSA (32.9°). In a first step, the moment arms for each muscle segment were obtained for 21 different thoracohumeral abduction angles to simulate a quasi-static abduction in the scapular plane. In a second step, the muscle forces were calculated by minimizing the range of muscle stresses able to compensate an external joint moment caused by the arm weight. If the joint became unstable, additional force was applied by the rotator cuff muscles to restore joint stability. The model showed a higher joint shear to joint compressive force for the RCT CSA (38.2°) for thoracohumeral abduction angles between 40° and 90° with a peak difference of 23% at 50° of abduction. To achieve stability in this case additional rotator cuff forces exceeding physiological values were required. Our results document that a higher CSA tends to destabilize the glenohumeral joint such that higher than normal supraspinatus forces are required to maintain modeled stability during active abduction. This lends strong support to the concept that a high CSA can induce supraspinatus (SSP) overload. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:961-968, 2016.
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Affiliation(s)
- Arnd F Viehöfer
- Department of Orthopedics, University of Zurich, Balgrist University Hospital, Zurich, Switzerland
| | - Christian Gerber
- Department of Orthopedics, University of Zurich, Balgrist University Hospital, Zurich, Switzerland
| | - Philippe Favre
- Department of Orthopedics, University of Zurich, Balgrist University Hospital, Zurich, Switzerland
| | - Elias Bachmann
- Department of Orthopedics, University of Zurich, Balgrist University Hospital, Zurich, Switzerland
| | - Jess G Snedeker
- Department of Orthopedics, University of Zurich, Balgrist University Hospital, Zurich, Switzerland.,Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
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Ding Z, Nolte D, Kit Tsang C, Cleather DJ, Kedgley AE, Bull AMJ. In Vivo Knee Contact Force Prediction Using Patient-Specific Musculoskeletal Geometry in a Segment-Based Computational Model. J Biomech Eng 2016; 138:021018. [DOI: 10.1115/1.4032412] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Indexed: 11/08/2022]
Abstract
Segment-based musculoskeletal models allow the prediction of muscle, ligament, and joint forces without making assumptions regarding joint degrees-of-freedom (DOF). The dataset published for the “Grand Challenge Competition to Predict in vivo Knee Loads” provides directly measured tibiofemoral contact forces for activities of daily living (ADL). For the Sixth Grand Challenge Competition to Predict in vivo Knee Loads, blinded results for “smooth” and “bouncy” gait trials were predicted using a customized patient-specific musculoskeletal model. For an unblinded comparison, the following modifications were made to improve the predictions: further customizations, including modifications to the knee center of rotation; reductions to the maximum allowable muscle forces to represent known loss of strength in knee arthroplasty patients; and a kinematic constraint to the hip joint to address the sensitivity of the segment-based approach to motion tracking artifact. For validation, the improved model was applied to normal gait, squat, and sit-to-stand for three subjects. Comparisons of the predictions with measured contact forces showed that segment-based musculoskeletal models using patient-specific input data can estimate tibiofemoral contact forces with root mean square errors (RMSEs) of 0.48–0.65 times body weight (BW) for normal gait trials. Comparisons between measured and predicted tibiofemoral contact forces yielded an average coefficient of determination of 0.81 and RMSEs of 0.46–1.01 times BW for squatting and 0.70–0.99 times BW for sit-to-stand tasks. This is comparable to the best validations in the literature using alternative models.
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Affiliation(s)
- Ziyun Ding
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Daniel Nolte
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Chui Kit Tsang
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Daniel J. Cleather
- School of Sport, Health and Applied Science, St Mary's University, Waldegrave Road, Twickenham TW1 4SX, UK e-mail:
| | - Angela E. Kedgley
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Anthony M. J. Bull
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
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de Vries W, Veeger H, Baten C, van der Helm F. Can shoulder joint reaction forces be estimated by neural networks? J Biomech 2016; 49:73-79. [DOI: 10.1016/j.jbiomech.2015.11.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 10/01/2015] [Accepted: 11/15/2015] [Indexed: 10/22/2022]
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Multi-Joint Compensatory Effects of Unilateral Total Knee Arthroplasty During High-Demand Tasks. Ann Biomed Eng 2015; 44:2529-2541. [PMID: 26666227 DOI: 10.1007/s10439-015-1524-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/29/2015] [Indexed: 01/01/2023]
Abstract
Patients with total knee arthroplasty (TKA) demonstrate quadriceps weakness and functional limitations 1 year after surgery during daily tasks such as walking and stair climbing. Most biomechanical analyses of patients after TKA focus on quadriceps function and rarely investigate other lower-extremity muscles or high-demand ambulatory activities of daily living. The purpose of this investigation was to quantify lower-extremity muscle forces in patients with unilateral TKA during high-demand tasks of pivoting and descending stairs. Five patients with unilateral TKA and five age and sex-matched controls performed three bilateral high-demand tasks: (1) step down from an 8-inch platform, (2) inside pivot: 90° direction change toward planted limb, and (3) outside pivot: 90° direction change away from planted limb. Subject-specific musculoskeletal simulations were created in OpenSim to determine joint angles, moments, and lower-extremity muscle forces. The results indicate that patients with TKA adopt compensatory strategies at both the hip and knee. Patients with TKA demonstrated increased hip external rotation, decreased knee flexion, decreased quadriceps force, and decreased hip abductor force in all three tasks. These strategies are likely a result of quadriceps avoidance, which may stem from instability after TKA or a habitual strategy developed during the late stages of osteoarthritis.
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Sins L, Tétreault P, Hagemeister N, Nuño N. Adaptation of the AnyBody™ Musculoskeletal Shoulder Model to the Nonconforming Total Shoulder Arthroplasty Context. J Biomech Eng 2015; 137:101006. [DOI: 10.1115/1.4031330] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Indexed: 11/08/2022]
Abstract
Current musculoskeletal inverse dynamics shoulder models have two limitations to use in the context of nonconforming total shoulder arthroplasty (NC-TSA). First, the ball and socket glenohumeral (GH) joint simplification avoids any humeral head translations. Second, there is no contact at the GH joint to compute the contact area and the center of pressure (COP) between the two components of NC-TSA. In this paper, we adapted the AnyBody™ shoulder model by introducing humeral head translations and contact between the two components of an NC-TSA. Abduction in the scapular plane was considered. The main objective of this study was to adapt the AnyBody™ shoulder model to a NC-TSA context and to compare the results of our model (translations, COP, contact area, GH joint reaction forces (GH-JRFs), and muscular forces) with previous numerical, experimental, and clinical studies. Humeral head translations and contact were successfully introduced in our adapted shoulder model with strong support for our findings by previous studies.
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Affiliation(s)
- Lauranne Sins
- Laboratoire de recherche en imagerie et orthopédie, Centre de recherche du CHUM, Montréal, QC H2X 0A9, Canada
- École de technologie supérieure, Montréal, QC H3C 1K3, Canada e-mail:
| | - Patrice Tétreault
- Orthopaedics Surgery Department, Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Local DR-1118-16, Montréal, QC H2L 4M1, Canada
- Laboratoire de recherche en imagerie et orthopédie, Centre de recherche du CHUM, Montréal, QC H2X 0A9, Canada e-mail:
| | - Nicola Hagemeister
- Department of GPA, École de technologie supérieure, Montréal, QC H3C 1K3, Canada
- Laboratoire de recherche en imagerie et orthopédie, Centre de recherche du CHUM, Montréal, QC H2X 0A9, Canada e-mail:
| | - Natalia Nuño
- Department of GPA, École de technologie supérieure, Montréal, QC H3C 1K3 Canada
- Laboratoire de recherche en imagerie et orthopédie, Centre de recherche du CHUM, Montréal, QC H2X 0A9, Canada e-mail:
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Ingram D, Engelhardt C, Farron A, Terrier A, Müllhaupt P. Improving anterior deltoid activity in a musculoskeletal shoulder model – an analysis of the torque-feasible space at the sternoclavicular joint. Comput Methods Biomech Biomed Engin 2015; 19:450-63. [DOI: 10.1080/10255842.2015.1042465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bolsterlee B, Vardy AN, van der Helm FCT, Veeger HEJD. The effect of scaling physiological cross-sectional area on musculoskeletal model predictions. J Biomech 2015; 48:1760-8. [PMID: 26050956 DOI: 10.1016/j.jbiomech.2015.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 03/17/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
Personalisation of model parameters is likely to improve biomechanical model predictions and could allow models to be used for subject- or patient-specific applications. This study evaluates the effect of personalising physiological cross-sectional areas (PCSA) in a large-scale musculoskeletal model of the upper extremity. Muscle volumes obtained from MRI were used to scale PCSAs of five subjects, for whom the maximum forces they could exert in six different directions on a handle held by the hand were also recorded. The effect of PCSA scaling was evaluated by calculating the lowest maximum muscle stress (σmax, a constant for human skeletal muscle) required by the model to reproduce these forces. When the original cadaver-based PCSA-values were used, strongly different between-subject σmax-values were found (σmax=106.1±39.9 N cm(-2)). A relatively simple, uniform scaling routine reduced this variation substantially (σmax=69.4±9.4 N cm(-2)) and led to similar results to when a more detailed, muscle-specific scaling routine was used (σmax=71.2±10.8 N cm(-2)). Using subject-specific PCSA values to simulate an shoulder abduction task changed muscle force predictions for the subscapularis and the pectoralis major on average by 33% and 21%, respectively, but was <10% for all other muscles. The glenohumeral (GH) joint contact force changed less than 1.5% as a result of scaling. We conclude that individualisation of the model's strength can most easily be done by scaling PCSA with a single factor that can be derived from muscle volume data or, alternatively, from maximum force measurements. However, since PCSA scaling only marginally changed muscle and joint contact force predictions for submaximal tasks, the need for PCSA scaling remains debatable.
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Affiliation(s)
- Bart Bolsterlee
- Department of Biomechanical Engineering and Biorobotics, Delft University of Technology (TU Delft), Delft, Netherlands.
| | - Alistair N Vardy
- Department of Biomechanical Engineering and Biorobotics, Delft University of Technology (TU Delft), Delft, Netherlands
| | - Frans C T van der Helm
- Department of Biomechanical Engineering and Biorobotics, Delft University of Technology (TU Delft), Delft, Netherlands
| | - H E J DirkJan Veeger
- Department of Biomechanical Engineering and Biorobotics, Delft University of Technology (TU Delft), Delft, Netherlands; Research Institutie MOVE, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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58
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Multi-patient finite element simulation of keeled versus pegged glenoid implant designs in shoulder arthroplasty. Med Biol Eng Comput 2015; 53:781-90. [DOI: 10.1007/s11517-015-1286-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
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59
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Vegter RJK, Hartog J, de Groot S, Lamoth CJ, Bekker MJ, van der Scheer JW, van der Woude LHV, Veeger DHEJ. Early motor learning changes in upper-limb dynamics and shoulder complex loading during handrim wheelchair propulsion. J Neuroeng Rehabil 2015; 12:26. [PMID: 25889389 PMCID: PMC4367846 DOI: 10.1186/s12984-015-0017-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/19/2015] [Indexed: 01/08/2023] Open
Abstract
Background To propel in an energy-efficient manner, handrim wheelchair users must learn to control the bimanually applied forces onto the rims, preserving both speed and direction of locomotion. Previous studies have found an increase in mechanical efficiency due to motor learning associated with changes in propulsion technique, but it is unclear in what way the propulsion technique impacts the load on the shoulder complex. The purpose of this study was to evaluate mechanical efficiency, propulsion technique and load on the shoulder complex during the initial stage of motor learning. Methods 15 naive able-bodied participants received 12-minutes uninstructed wheelchair practice on a motor driven treadmill, consisting of three 4-minute blocks separated by two minutes rest. Practice was performed at a fixed belt speed (v = 1.1 m/s) and constant low-intensity power output (0.2 W/kg). Energy consumption, kinematics and kinetics of propulsion technique were continuously measured. The Delft Shoulder Model was used to calculate net joint moments, muscle activity and glenohumeral reaction force. Results With practice mechanical efficiency increased and propulsion technique changed, reflected by a reduced push frequency and increased work per push, performed over a larger contact angle, with more tangentially applied force and reduced power losses before and after each push. Contrary to our expectations, the above mentioned propulsion technique changes were found together with an increased load on the shoulder complex reflected by higher net moments, a higher total muscle power and higher peak and mean glenohumeral reaction forces. Conclusions It appears that the early stages of motor learning in handrim wheelchair propulsion are indeed associated with improved technique and efficiency due to optimization of the kinematics and dynamics of the upper extremity. This process goes at the cost of an increased muscular effort and mechanical loading of the shoulder complex. This seems to be associated with an unchanged stable function of the trunk and could be due to the early learning phase where participants still have to learn to effectively use the full movement amplitude available within the wheelchair-user combination. Apparently whole body energy efficiency has priority over mechanical loading in the early stages of learning to propel a handrim wheelchair.
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Affiliation(s)
- Riemer J K Vegter
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.
| | - Johanneke Hartog
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.
| | - Sonja de Groot
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands. .,Amsterdam Rehabilitation Research Center Reade, Amsterdam, The Netherlands.
| | - Claudine J Lamoth
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.
| | - Michel J Bekker
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands. .,Swiss Paraplegic Research, Nottwil, Switzerland.
| | - Jan W van der Scheer
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.
| | - Lucas H V van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands. .,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands.
| | - Dirkjan H E J Veeger
- Faculty of Human Movement Sciences, Research Institute MOVE, Vrije Universiteit, Amsterdam, The Netherlands. .,Faculty of Mechanical, Maritime and Materials Engineering, Section Biomechatronics & Biorobotics, Delft University of Technology, Delft, The Netherlands.
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60
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Patel RJ, Choi D, Wright T, Gao Y. Nonconforming glenoid increases posterior glenohumeral translation after a total shoulder replacement. J Shoulder Elbow Surg 2014; 23:1831-1837. [PMID: 24939381 DOI: 10.1016/j.jse.2014.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/19/2014] [Accepted: 03/20/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND The major complication in nonconforming total shoulder replacement (TSR) is glenoid loosening and is attributed to posteriorly directed humeral head translations. Whether the posterior translations observed clinically are induced by radial mismatch is unclear. The objective of our study was to explain the posterior glenohumeral translations observed clinically after TSR by determining the glenohumeral translation and contact force as a function of radial mismatch. We hypothesized that the posterior direction of glenohumeral translation during scaption would be related to the radial mismatch and that the joint contact force would increase as the radial mismatch increased. METHODS A 6-degrees-of-freedom computational model of the glenohumeral joint was developed. We determined the muscle forces, joint contact force, and glenohumeral translation for radial mismatches from 1 mm to 20 mm with the shoulder positioned from 20° to 60° of scaption. RESULTS As the radial mismatch increased, the contact location of the humeral head moved posteriorly and inferiorly. The middle deltoid force decreased by 3%, while the supraspinatus and infraspinatus muscle forces increased by 9% and 11%, respectively. The joint contact force remained relatively constant. CONCLUSIONS Increased posterior glenohumeral translations were observed with increased radial mismatch. Clinical observations of posterior translation may be attributed to the balancing forces of the middle deltoid, infraspinatus, and supraspinatus muscles. High radial mismatches may lead to eccentric posterior loading on the glenoid component, which could lead to implant loosening and failure.
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Affiliation(s)
- Radhika J Patel
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Daniel Choi
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Timothy Wright
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Yingxin Gao
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA.
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Dumas R, Moissenet F, Lafon Y, Cheze L. Multi-objective optimisation for musculoskeletal modelling: application to a planar elbow model. Proc Inst Mech Eng H 2014; 228:1108-13. [PMID: 25361693 DOI: 10.1177/0954411914556790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
One of the open issues in musculoskeletal modelling remains the choice of the objective function that is used to solve the muscular redundancy problem. Some authors have recently proposed to introduce joint reaction forces in the objective function, and the question of the weights associated with musculo-tendon forces and joint reaction forces arose. This question typically deals with a multi-objective optimisation problem. The aim of this study is to illustrate, on a planar elbow model, the ensemble of optimal solutions (i.e. Pareto front) and the solution of a global objective method that represent different compromises between musculo-tendon forces, joint compression force, and joint shear force. The solutions of the global objective method, based either on the minimisation of the sum of the squared musculo-tendon forces alone or on the minimisation of the squared joint compression force and shear force together, are in the same range. Minimising either the squared joint compression force or shear force alone leads to extreme force values. The exploration of the compromises between these forces illustrates the existence of major interactions between the muscular and joint structures. Indeed, the joint reaction forces relate to the projection of the sum of the musculo-tendon forces. An illustration of these interactions, due to the projection relation, is that the Pareto front is not a large surface, like in a typical three-objective optimisation, but almost a curve. These interactions, and the possibility to take them into account by a multi-objective optimisation, seem essential for the application of musculoskeletal modelling to joint pathologies.
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Affiliation(s)
- Raphaël Dumas
- Université de Lyon, Lyon, France Université Claude Bernard Lyon 1, Villeurbanne, France UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), IFSTTAR, Bron, France
| | - Florent Moissenet
- Laboratoire d'Analyse du Mouvement et de la Posture, CNRFR - Rehazenter, Luxembourg, Luxembourg
| | - Yoann Lafon
- Université de Lyon, Lyon, France Université Claude Bernard Lyon 1, Villeurbanne, France UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), IFSTTAR, Bron, France
| | - Laurence Cheze
- Université de Lyon, Lyon, France Université Claude Bernard Lyon 1, Villeurbanne, France UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), IFSTTAR, Bron, France
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62
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Hoozemans MJM, Knelange EB, Frings-Dresen MHW, Veeger HEJ, Kuijer PPFM. Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies. Occup Environ Med 2014; 71:788-95. [PMID: 25035115 DOI: 10.1136/oemed-2013-101837] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms.
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Affiliation(s)
- M J M Hoozemans
- MOVE Research Institute, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands CORAL - Centre for Orthopaedic Research Alkmaar, Orthopaedic Outpatient Department, Medical Centre Alkmaar, Alkmaar, The Netherlands
| | - E B Knelange
- MOVE Research Institute, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health/Netherlands Center for Occupational Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - H E J Veeger
- MOVE Research Institute, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands Faculty of Mechanical, Material and Marine Engineering, Department of Biomechatronics and Biorobotics, Delft University of Technology, Amsterdam, The Netherlands
| | - P P F M Kuijer
- Coronel Institute of Occupational Health/Netherlands Center for Occupational Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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63
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Gerber C, Snedeker JG, Baumgartner D, Viehöfer AF. Supraspinatus tendon load during abduction is dependent on the size of the critical shoulder angle: A biomechanical analysis. J Orthop Res 2014; 32:952-7. [PMID: 24700399 DOI: 10.1002/jor.22621] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 02/28/2014] [Indexed: 02/04/2023]
Abstract
Shoulders with supraspinatus (SSP) tears are associated with significantly larger critical shoulder angles (CSA) compared to disease-free shoulders. We hypothesized that larger CSAs increase the ratio of joint shear to joint compression forces (defined as "instability ratio"), requiring substantially increased compensatory supraspinatus loads. A shoulder simulator with simulated deltoid, supraspinatus, infraspinatus/teres minor, and subscapularis musculotendinous units was constructed. The model was configured to represent either a normal CSA of 33° or a CSA characteristic of shoulders with rotator cuff tears (38°), and the components of the joint forces were measured. The instability ratio increased for the 38° CSA compared with the control CSA (33°) for a range of motion between 6° to 61° of thoracohumeral abduction with the largest differences in instability observed between 33° and 37° of elevation. In this range, SSP force had to be increased by 13-33% (15-23 N) to stabilize the arm in space. Our results support the concept that a high CSA can induce SSP overload particularly at low degrees of active abduction.
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Affiliation(s)
- Christian Gerber
- Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
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64
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Prinold JAI, Bull AMJ. Scaling and kinematics optimisation of the scapula and thorax in upper limb musculoskeletal models. J Biomech 2014; 47:2813-9. [PMID: 25011621 PMCID: PMC4150986 DOI: 10.1016/j.jbiomech.2014.05.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 11/27/2022]
Abstract
Accurate representation of individual scapula kinematics and subject geometries is vital in musculoskeletal models applied to upper limb pathology and performance. In applying individual kinematics to a model׳s cadaveric geometry, model constraints are commonly prescriptive. These rely on thorax scaling to effectively define the scapula׳s path but do not consider the area underneath the scapula in scaling, and assume a fixed conoid ligament length. These constraints may not allow continuous solutions or close agreement with directly measured kinematics. A novel method is presented to scale the thorax based on palpated scapula landmarks. The scapula and clavicle kinematics are optimised with the constraint that the scapula medial border does not penetrate the thorax. Conoid ligament length is not used as a constraint. This method is simulated in the UK National Shoulder Model and compared to four other methods, including the standard technique, during three pull-up techniques (n=11). These are high-performance activities covering a large range of motion. Model solutions without substantial jumps in the joint kinematics data were improved from 23% of trials with the standard method, to 100% of trials with the new method. Agreement with measured kinematics was significantly improved (more than 10° closer at p<0.001) when compared to standard methods. The removal of the conoid ligament constraint and the novel thorax scaling correction factor were shown to be key. Separation of the medial border of the scapula from the thorax was large, although this may be physiologically correct due to the high loads and high arm elevation angles.
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Affiliation(s)
- Joe A I Prinold
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK.
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Campoli G, Bolsterlee B, van der Helm F, Weinans H, Zadpoor AA. Effects of densitometry, material mapping and load estimation uncertainties on the accuracy of patient-specific finite-element models of the scapula. J R Soc Interface 2014; 11:20131146. [PMID: 24522784 DOI: 10.1098/rsif.2013.1146] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Patient-specific biomechanical models including patient-specific finite-element (FE) models are considered potentially important tools for providing personalized healthcare to patients with musculoskeletal diseases. A multi-step procedure is often needed to generate a patient-specific FE model. As all involved steps are associated with certain levels of uncertainty, it is important to study how the uncertainties of individual components propagate to final simulation results. In this study, we considered a specific case of this problem where the uncertainties of the involved steps were known and the aim was to determine the uncertainty of the predicted strain distribution. The effects of uncertainties of three important components of patient-specific models, including bone density, musculoskeletal loads and the parameters of the material mapping relationship on the predicted strain distributions, were studied. It was found that the number of uncertain components and the level of their uncertainty determine the uncertainty of simulation results. The 'average' uncertainty values were found to be relatively small even for high levels of uncertainty in the components of the model. The 'maximum' uncertainty values were, however, quite high and occurred in the areas of the scapula that are of the greatest clinical relevance. In addition, the uncertainty of the simulation result was found to be dependent on the type of movement analysed, with abduction movements presenting consistently lower uncertainty values than flexion movements.
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Affiliation(s)
- Gianni Campoli
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), , Mekelweg 2, Delft 2628 CD, The Netherlands
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Quental C, Folgado J, Ambrósio J, Monteiro J. Critical analysis of musculoskeletal modelling complexity in multibody biomechanical models of the upper limb. Comput Methods Biomech Biomed Engin 2013; 18:749-59. [DOI: 10.1080/10255842.2013.845879] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Campoli G, Weinans H, van der Helm F, Zadpoor AA. Subject-specific modeling of the scapula bone tissue adaptation. J Biomech 2013; 46:2434-41. [PMID: 23938055 DOI: 10.1016/j.jbiomech.2013.07.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 07/12/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
Abstract
Adaptation of the scapula bone tissue to mechanical loading is simulated in the current study using a subject-specific three-dimensional finite element model of an intact cadaveric scapula. The loads experienced by the scapula during different types of movements are determined using a subject-specific large-scale musculoskeletal model of the shoulder joint. The obtained density distributions are compared with the CT-measured density distribution of the same scapula. Furthermore, it is assumed that the CT-measured density distribution can be estimated as a weighted linear combination of the density distributions calculated for different loads experienced during daily life. An optimization algorithm is used to determine the weighting factors of fourteen different loads such that the difference between the weighted linear combination of the calculated density distributions and the CT-measured density is minimal. It is shown that the weighted linear combination of the calculated densities matches the CT-measured density distribution better than every one of the density distributions calculated for individual movements. The weighting factors of nine out of fourteen loads were estimated to be zero or very close to zero. The five loads that had larger weighting factors were associated with either one of the following categories: (1) small-load small-angle abduction or flexion movements that occur frequently during our daily lives or (2) large-load large-angle abduction or flexion movements that occur infrequently during our daily lives.
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Affiliation(s)
- Gianni Campoli
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands
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Clinical applications of musculoskeletal modelling for the shoulder and upper limb. Med Biol Eng Comput 2013; 51:953-63. [PMID: 23873010 DOI: 10.1007/s11517-013-1099-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
Abstract
Musculoskeletal models have been developed to estimate internal loading on the human skeleton, which cannot directly be measured in vivo, from external measurements like kinematics and external forces. Such models of the shoulder and upper extremity have been used for a variety of purposes, ranging from understanding basic shoulder biomechanics to assisting in preoperative planning. In this review, we provide an overview of the most commonly used large-scale shoulder and upper extremity models and categorise the applications of these models according to the type of questions their users aimed to answer. We found that the most explored feature of a model is the possibility to predict the effect of a structural adaptation on functional outcome, for instance, to simulate a tendon transfer preoperatively. Recent studies have focused on minimising the mismatch in morphology between the model, often derived from cadaver studies, and the subject that is analysed. However, only a subset of the parameters that describe the model's geometry and, perhaps most importantly, the musculotendon properties can be obtained in vivo. Because most parameters are somehow interrelated, the others should be scaled to prevent inconsistencies in the model's structure, but it is not known exactly how. Although considerable effort is put into adding complexity to models, for example, by making them subject-specific, we have found little evidence of their superiority over current models. The current trend in development towards individualised, more complex models needs to be justified by demonstrating their ability to answer questions that cannot already be answered by existing models.
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Prinold JAI, Masjedi M, Johnson GR, Bull AMJ. Musculoskeletal shoulder models: A technical review and proposals for research foci. Proc Inst Mech Eng H 2013; 227:1041-57. [DOI: 10.1177/0954411913492303] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Musculoskeletal shoulder models allow non-invasive prediction of parameters that cannot be measured, particularly the loading applied to morphological structures and neurological control. This insight improves treatment and avoidance of pathology and performance evaluation and optimisation. A lack of appropriate validation and knowledge of model parameters’ accuracy may cause reduced clinical success for these models. Instrumented implants have recently been used to validate musculoskeletal models, adding important information to the literature. This development along with increasing prevalence of shoulder models necessitates a fresh review of available models and their utility. The practical uses of models are described. Accuracy of model inputs, modelling techniques and model sensitivity is the main technical review undertaken. Collection and comparison of these parameters are vital to understanding disagreement between model outputs. Trends in shoulder modelling are highlighted: validation through instrumented prostheses, increasing openness and strictly constrained, optimised, measured kinematics. Future directions are recommended: validation through focus on model sub-sections, increased subject specificity with imaging techniques determining muscle and body segment parameters and through different scaling and kinematics optimisation approaches.
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Affiliation(s)
- Joe AI Prinold
- Department of Bioengineering, Imperial College London, London, UK
| | - Milad Masjedi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Garth R Johnson
- Bioengineering Research Group, School of Mechanical and Systems Engineering, Newcastle University, Newcastle upon Tyne, UK
| | - Anthony MJ Bull
- Department of Bioengineering, Imperial College London, London, UK
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van Drongelen S, Schlüssel M, Arnet U, Veeger D. The influence of simulated rotator cuff tears on the risk for impingement in handbike and handrim wheelchair propulsion. Clin Biomech (Bristol, Avon) 2013; 28:495-501. [PMID: 23664372 DOI: 10.1016/j.clinbiomech.2013.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 04/12/2013] [Accepted: 04/16/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rotator cuff tears strongly affect the biomechanics of the shoulder joint in their role to regulate the joint contact force needed to prevent the joint from dislocation. The aim of this study was to investigate the influence of simulated progressed rotator cuff tears on the (in)stability of the glenohumeral joint and the risk for impingement during wheelchair and handbike propulsion. METHODS The Delft Shoulder and Elbow Model was used to calculate the magnitude of the glenohumeral joint reaction force and the objective function J, which is an indication of the effort needed to complete the task. Full-thickness tears were simulated by virtually removing muscles from the model. FINDINGS With larger cuff tears the joint reaction force was higher and more superiorly directed. Also extra muscle force was necessary to balance the external force such that the glenohumeral joint did not dislocate. INTERPRETATION A tear of only the supraspinatus leads only to a minor increase in muscle forces and a minor shift of the force on the glenoid, indicating that it is possible to function well with a torn supraspinatus muscle. A massive tear shifts the direction of the joint reaction force to the superior border of the glenoid, increasing the risk for impingement.
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71
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Modelling clavicular and scapular kinematics: from measurement to simulation. Med Biol Eng Comput 2013; 52:283-91. [DOI: 10.1007/s11517-013-1065-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 03/18/2013] [Indexed: 11/25/2022]
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NIKOOYAN ALIA, VEEGER HEJ, WESTERHOFF PETER, BERGMANN GEORG, VAN DER HELM FRANSCT. RELATIVE CONTRIBUTION OF DIFFERENT MUSCLE ENERGY CONSUMPTION PROCESSES IN AN ENERGY-BASED MUSCLE LOAD SHARING COST FUNCTION. J MECH MED BIOL 2013. [DOI: 10.1142/s0219519413500097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study is to quantify the relative contributions of two muscle energy consumption processes (the detachment of cross-bridges and calcium-pumping) incorporated in a recently developed muscle load sharing cost function, namely the energy-based criterion, by using in vivo measured glenohumeral-joint reaction forces (GH-JRFs). Motion data and in vivo GH-JRFs were recorded for four patients carrying an instrumented shoulder implant while performing abduction and forward flexion motions up to their maximum possible arm elevations. Motion data were used as the input to the delft shoulder and elbow model for the estimation of GH-JRFs. The widely used stress as well as the energy-based cost functions were adopted as the load sharing criteria. For the energy-based criterion, simulations were run for a wide range of different weight parameters (determining the relative contribution of the two energy processes) in the neighborhood of the previously assumed parameters for each subject and motion. The model-predicted and in vivo-measured GH-JRFs were compared for all model simulations. Application of the energy-based criterion with new identified parameters resulted in significant (two-tailed p < 0.05, post-hoc power ~ 0.3) improvement (on average ~20%) of the model-predicted GH-JRFs at the maximal arm elevation compared to when using either the stress or the pre-assumed form of the energy-based criterion. About 25% of the total energy consumption was calculated for the calcium-pumping process at maximal muscle activation level when using the new parameters. This value was comparable to the corresponding ones reported in the previous literature. The identified parameters are recommended to be used instead of their predecessors.
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Affiliation(s)
- ALI A. NIKOOYAN
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft 2628CD, The Netherlands
| | - HEJ VEEGER
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft 2628CD, The Netherlands
- Research Institute Move, VU Amsterdam, Van der Boechorststraat 9, 1081BT Amsterdam, The Netherlands
| | - PETER WESTERHOFF
- Julius Wolff Institut, Charité, Universitätsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - GEORG BERGMANN
- Julius Wolff Institut, Charité, Universitätsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - FRANS C. T. VAN DER HELM
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, Delft 2628CD, The Netherlands
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Arnet U, van Drongelen S, Schlüssel M, Lay V, van der Woude LHV, Veeger HEJ. The effect of crank position and backrest inclination on shoulder load and mechanical efficiency during handcycling. Scand J Med Sci Sports 2012; 24:386-94. [PMID: 22989023 DOI: 10.1111/j.1600-0838.2012.01524.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2012] [Indexed: 11/26/2022]
Abstract
Handbikes come in different models and setups, but only limited knowledge is available on the handbike-user interface. The aim of this study was to identify optimal handbike setups, assuming that in such a setup mechanical efficiency is high, while shoulder load is low. Thirteen subjects with a spinal cord injury (paraplegia) performed handcycling with different handbike setups at constant power output: four crank positions (two distances, two heights) and four backrest inclinations. The O2-consumption, kinetics, and kinematics were measured to calculate mechanical efficiency and shoulder load (glenohumeral contact force, net shoulder moments, and rotator cuff force). The analysis showed that more upright backrest positions resulted in lower shoulder load compared with the most reclined position [glenohumeral contact force (260 vs 335 N), supraspinatus (14.4% vs 18.2%), and infraspinatus force (5.4% vs 9.8%)], while there was no difference in efficiency. Except for a reduction in subscapularis force at the distant position, no differences in shoulder load or efficiency were found between crank positions. Recreational handbike users, who want to improve their physical capacity in a shoulder-friendly way, should set up their handbike with a more upright backrest position and a distant crank placement.
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Affiliation(s)
- U Arnet
- Swiss Paraplegic Research, Nottwil, Switzerland; Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
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Favre P, Senteler M, Hipp J, Scherrer S, Gerber C, Snedeker JG. An integrated model of active glenohumeral stability. J Biomech 2012; 45:2248-55. [DOI: 10.1016/j.jbiomech.2012.06.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 06/07/2012] [Accepted: 06/09/2012] [Indexed: 01/02/2023]
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75
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An EMG-driven musculoskeletal model of the shoulder. Hum Mov Sci 2012; 31:429-47. [DOI: 10.1016/j.humov.2011.08.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 08/17/2011] [Accepted: 08/31/2011] [Indexed: 11/23/2022]
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Fregly BJ, Boninger ML, Reinkensmeyer DJ. Personalized neuromusculoskeletal modeling to improve treatment of mobility impairments: a perspective from European research sites. J Neuroeng Rehabil 2012; 9:18. [PMID: 22463378 PMCID: PMC3342221 DOI: 10.1186/1743-0003-9-18] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 03/30/2012] [Indexed: 05/26/2023] Open
Abstract
Mobility impairments due to injury or disease have a significant impact on quality of life. Consequently, development of effective treatments to restore or replace lost function is an important societal challenge. In current clinical practice, a treatment plan is often selected from a standard menu of options rather than customized to the unique characteristics of the patient. Furthermore, the treatment selection process is normally based on subjective clinical experience rather than objective prediction of post-treatment function. The net result is treatment methods that are less effective than desired at restoring lost function. This paper discusses the possible use of personalized neuromusculoskeletal computer models to improve customization, objectivity, and ultimately effectiveness of treatments for mobility impairments. The discussion is based on information gathered from academic and industrial research sites throughout Europe, and both clinical and technical aspects of personalized neuromusculoskeletal modeling are explored. On the clinical front, we discuss the purpose and process of personalized neuromusculoskeletal modeling, the application of personalized models to clinical problems, and gaps in clinical application. On the technical front, we discuss current capabilities of personalized neuromusculoskeletal models along with technical gaps that limit future clinical application. We conclude by summarizing recommendations for future research efforts that would allow personalized neuromusculoskeletal models to make the greatest impact possible on treatment design for mobility impairments.
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Affiliation(s)
- Benjamin J Fregly
- Department of Mechanical & Aerospace Engineering, University of Florida, 231 MAE-A Building, PO Box 116250, Gainesville, FL 32611-6250, USA.
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Trepczynski A, Kutzner I, Kornaropoulos E, Taylor WR, Duda GN, Bergmann G, Heller MO. Patellofemoral joint contact forces during activities with high knee flexion. J Orthop Res 2012; 30:408-15. [PMID: 22267190 DOI: 10.1002/jor.21540] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 08/01/2011] [Indexed: 02/04/2023]
Abstract
The patellofemoral (PF) joint plays an essential role in knee function, but little is known about the in vivo loading conditions at the joint. We hypothesized that the forces at the PF joint exceed the tibiofemoral (TF) forces during activities with high knee flexion. Motion analysis was performed in two patients with telemetric knee implants during walking, stair climbing, sit-to-stand, and squat. TF and PF forces were calculated using a musculoskeletal model, which was validated against the simultaneously measured in vivo TF forces, with mean errors of 10% and 21% for the two subjects. The in vivo peak TF forces of 2.9-3.4 bodyweight (BW) varied little across activities, while the peak PF forces showed significant variability, ranging from less than 1 BW during walking to more than 3 BW during high flexion activities, exceeding the TF forces. Together with previous in vivo measurements at the hip and knee, the PF forces determined here provide evidence that peak forces across these joints reach values of around 3 BW during high flexion activities, also suggesting that the in vivo loading conditions at the knee can only be fully understood if the forces at the TF and the PF joints are considered together.
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Affiliation(s)
- Adam Trepczynski
- Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Centrum für Sportwissenschaft und Sportmedizin Berlin (CSSB), Philippstraße 13, Haus 11, 10115 Berlin, Germany
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Lemieux PO, Hagemeister N, Tétreault P, Nuño N. Influence of the medial offset of the proximal humerus on the glenohumeral destabilising forces during arm elevation: a numerical sensitivity study. Comput Methods Biomech Biomed Engin 2012; 16:103-11. [PMID: 22309002 DOI: 10.1080/10255842.2011.607813] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This study assessed the influence of the medial offset of the proximal humerus on the glenohumeral destabilising forces during arm elevation in the plane of the scapula, using the AnyBody Modeling System. The variability of the medial offset was covered using literature data (minimum, 0 mm; average, 7 mm and maximum, 14 mm). The following parameters were studied: moment arm (MA; middle deltoid), muscle activity and stability ratios. The minimum offset decreased the MA of the middle deltoid ( -11%), increased its activation (+18%) and its superior destabilising action (+40%). The maximum offset had an opposite effect (+9%, -30% and -30%). The stabilising action of the rotator cuff was not affected. Varying the medial offset seems to have an influence on the destabilising action of the middle deltoid. The AnyBody simulation tool appears to be promising in establishing links between shoulder morphology and stability.
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Affiliation(s)
- P O Lemieux
- Laboratoire de Recherche en Imagerie et Orthopédie, École de Technologie Supérieure, Montreal, Canada.
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Shoulder load during handcycling at different incline and speed conditions. Clin Biomech (Bristol, Avon) 2012; 27:1-6. [PMID: 21831491 DOI: 10.1016/j.clinbiomech.2011.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 06/29/2011] [Accepted: 07/01/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND The manual wheelchair user population experiences a high prevalence of upper-limb injuries, which are related to a high load on the shoulder joint during activities of daily living, such as handrim wheelchair propulsion. An alternative mode of propulsion is handcycling, where lower external forces are suggested to be applied to reach the same power output as in handrim wheelchair propulsion. This study aimed to quantify glenohumeral contact forces and muscle forces during handcycling and compare them to previous results of handrim wheelchair propulsion. METHODS Ten able-bodied men propelled the handbike on a treadmill at two inclines (1% and 4% with a velocity of 1.66 m/s) and two speed conditions (1.39 and 1.94 m/s with fixed power output). Three-dimensional kinematics and kinetics were obtained and used as input for a musculoskeletal model of the arm and shoulder. Output variables were glenohumeral contact forces and forces of important shoulder muscles. FINDINGS The highest mean and peak glenohumeral contact forces occurred at 4% incline (420 N, 890 N respectively). The scapular part of the deltoideus, the triceps and the trapezius produced the highest force. INTERPRETATION Due to the circular movement and the continuous force application during handcycling, the glenohumeral contact forces, as well as the muscle forces were clearly lower compared to the results in the existing literature on wheelchair propulsion. These findings prove the assumption that handcycling is mechanically less straining than handrim wheelchair propulsion, which may help preventing overuse to the shoulder complex.
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80
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Nikooyan AA, Veeger HEJ, Chadwick EKJ, Praagman M, Helm FCTVD. Development of a comprehensive musculoskeletal model of the shoulder and elbow. Med Biol Eng Comput 2011; 49:1425-35. [PMID: 22038240 PMCID: PMC3223593 DOI: 10.1007/s11517-011-0839-7] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 10/10/2011] [Indexed: 11/13/2022]
Abstract
The Delft Shoulder and Elbow Model (DSEM), a musculoskeletal model of the shoulder and elbow has been extensively developed since its introduction in 1994. Extensions cover both model structures and anatomical data focusing on the addition of an elbow part and muscle architecture parameters. The model was also extended with a new inverse-dynamics optimization cost function and combined inverse-forward-dynamics models. This study is an update on the developments of the model over the last decade including a qualitative validation of the different simulation architectures available in the DSEM. To validate the model, a dynamic forward flexion motion was performed by one subject, of which the motion data and surface EMG-signals of 12 superficial muscles were measured. Patterns of the model-predicted relative muscle forces were compared with their normalized EMG-signals. Results showed relatively good agreement between forces and EMG (mean correlation coefficient of 0.66). However, for some cases, no force was predicted while EMG activity had been measured (false-negatives). The DSEM has been used and has the potential to be used in a variety of clinical and biomechanical applications.
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Affiliation(s)
- A Asadi Nikooyan
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
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81
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Nikooyan AA, Zadpoor AA. Mass–spring–damper modelling of the human body to study running and hopping – an overview. Proc Inst Mech Eng H 2011; 225:1121-35. [DOI: 10.1177/0954411911424210] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several mass–spring–damper models have been developed to study the response of the human body to the collision with the ground during hopping, trotting, or running. The mass, spring, and damper elements represent the masses, stiffness properties, and damping properties of hard and soft tissues. The masses that models are composed of are connected to each other via springs and dampers. The present paper reviews the various types of mass–spring–damper models including one-body and multi-body models. The models are further categorized as being either passive or active. In passive models, the mechanical properties (stiffness and damping) of soft tissues remain constant regardless of the type of footwear, ground stiffness, etc. In active models, the mechanical properties adapt to external loads. The governing equations of motion of all models as well as their parameters are presented. The specific ways that the models take account of the shoe–ground interactions are discussed as well. The methods used for determination of different modelling parameters are briefly surveyed. The advantages and disadvantages of the different types of mass–spring–damper models are also discussed. The paper concludes with a brief discussion of possible future research trends in the area of mass–spring–damper modelling.
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Affiliation(s)
- A A Nikooyan
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - A A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
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82
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Modenese L, Phillips A, Bull A. An open source lower limb model: Hip joint validation. J Biomech 2011; 44:2185-93. [DOI: 10.1016/j.jbiomech.2011.06.019] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 06/06/2011] [Accepted: 06/15/2011] [Indexed: 11/16/2022]
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van Drongelen S, van der Woude LHV, Veeger HEJ. Load on the shoulder complex during wheelchair propulsion and weight relief lifting. Clin Biomech (Bristol, Avon) 2011; 26:452-7. [PMID: 21316822 DOI: 10.1016/j.clinbiomech.2011.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 01/12/2011] [Accepted: 01/13/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study focuses on the relationship between overuse in association with wheelchair activities of daily living and risks for osteoarthrosis in the acromioclavicular and sternoclavicular joints. The aim is to quantify the joint moments and joint reaction forces in all three joints of the shoulder complex during wheelchair-related activities of daily living. METHODS A convenience sample of 17 subjects performed two tasks (wheelchair propulsion and weight relief lifting). Three-dimensional kinematics and kinetics were measured and position and force data were used as input for a musculoskeletal model of the arm and shoulder. Output variables of the model were the moments and the joint reaction forces on the sternoclavicular, acromioclavicular and glenohumeral joints. FINDINGS Moments on the sternoclavicular joint were higher than on the acromioclavicular and glenohumeral joint, but the joint reaction forces on the sternoclavicular and acromioclavicular joints were only one third of those on the glenohumeral joint (peak forces around 96N compared to 315N for wheelchair propulsion and around 330N compared to 1288N for weight relief lifting). INTERPRETATION Based on the results found in this study, net joint moments are likely a better measure to describe the load on the acromioclavicular and sternoclavicular joints due to the passive stabilization. Prospective studies on wheelchair overuse injuries should also look at the acromioclavicular and sternoclavicular joints since the load of wheelchair tasks might be a risk factor for osteoarthrosis in these joints.
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Affiliation(s)
- S van Drongelen
- Swiss Paraplegic Research, Guido A Zächstrasse 4, Nottwil, Switzerland.
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Jaspers E, Feys H, Bruyninckx H, Cutti A, Harlaar J, Molenaers G, Desloovere K. The reliability of upper limb kinematics in children with hemiplegic cerebral palsy. Gait Posture 2011; 33:568-75. [PMID: 21334208 DOI: 10.1016/j.gaitpost.2011.01.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 01/13/2011] [Accepted: 01/15/2011] [Indexed: 02/02/2023]
Abstract
This study describes the reliability of a protocol for upper limb three-dimensional movement analysis (UL-3DMA) in children with hemiplegic cerebral palsy (HCP). The UL-3DMA is based on the ISB-recommendations, and contains a set of functional and clinically relevant tasks. Tasks were selected to reflect the characteristic movement deficits seen in children with HCP. The protocol consists of three reach tasks (forwards, upwards, sideways); two reach-to-grasp tasks (with objects requiring different hand orientations); and three gross motor tasks. Within and between session reliability was tested in a group of 12 children with HCP, aged 6-15 years. Reliability of movement duration/speed and joint angles at endpoint was assessed with the intraclass correlation coefficient; similarity of the waveforms with the coefficient of multiple correlation. Measurement errors were calculated for all parameters. Results indicated good within and between session reliability for movement duration/speed. Trunk, scapula, shoulder, elbow and wrist angles at endpoint generally showed moderately high to very high reliability. High levels of reliability were also found for scapula, shoulder and elbow waveforms and lower levels for the wrist and trunk. Within and between session measurement errors were below 5° and 7°, respectively, for most kinematic parameters. Joint angles in the transverse plane, as well as wrist flexion generally showed higher between session errors (7-10°). This study indicates that the proposed protocol is a reliable tool to quantify upper limb movements in children with HCP, providing a sound base for its clinical application. Further research is needed to establish the discriminative ability of the UL-3DMA.
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Affiliation(s)
- Ellen Jaspers
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium.
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Nikooyan AA, van der Helm FCT, Westerhoff P, Graichen F, Bergmann G, Veeger HEJD. Comparison of two methods for in vivo estimation of the glenohumeral joint rotation center (GH-JRC) of the patients with shoulder hemiarthroplasty. PLoS One 2011; 6:e18488. [PMID: 21483808 PMCID: PMC3069111 DOI: 10.1371/journal.pone.0018488] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 03/09/2011] [Indexed: 11/19/2022] Open
Abstract
Determination of an accurate glenohumeral-joint rotation center (GH-JRC) from marker data is essential for kinematic and dynamic analysis of shoulder motions. Previous studies have focused on the evaluation of the different functional methods for the estimation of the GH-JRC for healthy subjects. The goal of this paper is to compare two widely used functional methods, namely the instantaneous helical axis (IHA) and symmetrical center of rotation (SCoRE) methods, for estimating the GH-JRC in vivo for patients with implanted shoulder hemiarthroplasty. The motion data of five patients were recorded while performing three different dynamic motions (circumduction, abduction, and forward flexion). The GH-JRC was determined using the CT-images of the subjects (geometric GH-JRC) and was also estimated using the two IHA and SCoRE methods. The rotation centers determined using the IHA and SCoRE methods were on average 1.47±0.62 cm and 2.07±0.55 cm away from geometric GH-JRC, respectively. The two methods differed significantly (two-tailed p-value from paired t-Test ∼0.02, post-hoc power ∼0.30). The SCoRE method showed a significant lower (two-tailed p-value from paired t-Test ∼0.03, post-hoc power ∼0.68) repeatability error calculated between the different trials of each motion and each subject and averaged across all measured subjects (0.62±0.10 cm for IHA vs. 0.43±0.12 cm for SCoRE). It is concluded that the SCoRE appeared to be a more repeatable method whereas the IHA method resulted in a more accurate estimation of the GH-JRC for patients with endoprostheses.
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Affiliation(s)
- Ali Asadi Nikooyan
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.
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