351
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A 3D lower limb musculoskeletal model for simultaneous estimation of musculo-tendon, joint contact, ligament and bone forces during gait. J Biomech 2014; 47:50-8. [DOI: 10.1016/j.jbiomech.2013.10.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 10/11/2013] [Accepted: 10/12/2013] [Indexed: 11/22/2022]
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352
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Kim W, Veloso AP, Araújo D, Kohles SS. Novel computational approaches characterizing knee physiotherapy. JOURNAL OF COMPUTATIONAL DESIGN AND ENGINEERING 2014; 1:55-66. [PMID: 37123075 PMCID: PMC10137317 DOI: 10.7315/jcde.2014.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A knee joint's longevity depends on the proper integration of structural components in an axial alignment. If just one of the components is abnormally off-axis, the biomechanical system fails, resulting in arthritis. The complexity of various failures in the knee joint has led orthopedic surgeons to select total knee replacement as a primary treatment. In many cases, this means sacrificing much of an otherwise normal joint. Here, we review novel computational approaches to describe knee physiotherapy by introducing a new dimension of foot loading to the knee axis alignment producing an improved functional status of the patient. New physiotherapeutic applications are then possible by aligning foot loading with the functional axis of the knee joint during the treatment of patients with osteoarthritis.
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Affiliation(s)
- Wangdo Kim
- Univ Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002, Lisbon, Portugal
| | - António P. Veloso
- Univ Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002, Lisbon, Portugal
| | - Duarte Araújo
- Univ Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002, Lisbon, Portugal
| | - Sean S. Kohles
- Division of Biomaterials & Biomechanics, Department of Restorative Dentistry, Oregon Health & Science University, Portland, Oregon, USA
- Corresponding author. Tel.: +1-503-516-7528,
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353
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The application of computer musculoskeletal modeling and simulation to investigate compressive tibiofemoral force and muscle functions in obese children. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2013; 2013:305434. [PMID: 24288573 PMCID: PMC3833069 DOI: 10.1155/2013/305434] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 09/04/2013] [Accepted: 09/17/2013] [Indexed: 11/17/2022]
Abstract
This study aimed to utilize musculoskeletal modelling and simulation to investigate the compressive tibiofemoral force and individual muscle function in obese children. We generated a 3D muscle-driven simulation of eight obese and eight normal-weight boys walking at their self-selected speed. The compressive tibiofemoral force and individual muscle contribution to the support and progression accelerations of center of mass (COM) were computed for each participant based on the subject-specific model. The simulated results were verified by comparing them to the experimental kinematics and EMG data. We found a linear relationship between the average self-selected speed and the normalized peak compressive tibiofemoral force (R2 = 0.611). The activity of the quadriceps contributed the most to the peak compressive tibiofemoral force during the stance phase. Obese children and nonobese children use similar muscles to support and accelerate the body COM, but nonobese children had significantly greater contributions of individual muscles. The obese children may therefore adopt a compensation strategy to avoid increasing joint loads and muscle requirements during walking. The absolute compressive tibiofemoral force and muscle forces were still greater in obese children. The long-term biomechanical adaptations of the musculoskeletal system to accommodate the excess body weight during walking are a concern.
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354
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Worsley P, Stokes M, Barrett D, Taylor M. Joint loading asymmetries in knee replacement patients observed both pre- and six months post-operation. Clin Biomech (Bristol, Avon) 2013; 28:892-7. [PMID: 23968817 DOI: 10.1016/j.clinbiomech.2013.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 06/24/2013] [Accepted: 07/23/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Studies have highlighted asymmetries in knee joint moments in individuals with osteoarthritis and joint replacements. However, there is a need to investigate the forces at the knee joints to establish the extent of loading asymmetries. METHODS Twenty healthy (mean age, 62; range, 55-79 years) and 34 pre- to post-knee arthroplasty (mean age, 64; range, 39-79 years) participants performed gait and sit-stand activities in a motion capture laboratory. Knee joint forces and moments were predicted using inverse dynamics and used to calculate peak loading and impulse data which were normalized to body weight. Comparisons were made between affected and contralateral limbs, and changes from pre- to post-knee arthroplasty. FINDINGS Pre-knee arthroplasty peak vertical knee forces were greater in the contralateral limb compared to the affected limb during both gait 3.5 vs. 3.2 ∗ body weight and sit-stand 1.8 vs. 1.5 ∗ body weight. During gait, peak knee adduction moment asymmetries significantly changed from pre- to post-knee arthroplasty (-0.3 to 0.8 ∗ % body weight ∗ m ∗ height), although differences in vertical knee forces remained. There were no significant changes in loading during sit-stand from pre- to post-knee arthroplasty. The healthy participants showed no noteworthy asymmetries. INTERPRETATION This study showed loading asymmetries in knee forces between affected and contralateral limbs both pre- and post-knee arthroplasty. Continued over reliance of the contralateral limb could lead to pathology.
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Affiliation(s)
- Peter Worsley
- Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; Bioengineering Science Research Group, School of Engineering Sciences, University of Southampton, Southampton, UK; Shadow Musculoskeletal Biomedical Research Unit (sMBRU), University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
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355
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Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, Beavers DP, Hunter DJ, Lyles MF, Eckstein F, Williamson JD, Carr JJ, Guermazi A, Loeser RF. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA 2013; 310:1263-73. [PMID: 24065013 PMCID: PMC4450354 DOI: 10.1001/jama.2013.277669] [Citation(s) in RCA: 547] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity. OBJECTIVE To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone. DESIGN, SETTING, AND PARTICIPANTS Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. Participants were 454 overweight and obese older community-dwelling adults (age ≥55 years with body mass index of 27-41) with pain and radiographic knee OA. INTERVENTIONS Intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise. MAIN OUTCOMES AND MEASURES Mechanistic primary outcomes: knee joint compressive force and plasma IL-6 levels; secondary clinical outcomes: self-reported pain (range, 0-20), function (range, 0-68), mobility, and health-related quality of life (range, 0-100). RESULTS Three hundred ninety-nine participants (88%) completed the study. Mean weight loss for diet + exercise participants was 10.6 kg (11.4%); for the diet group, 8.9 kg (9.5%); and for the exercise group, 1.8 kg (2.0%). After 18 months, knee compressive forces were lower in diet participants (mean, 2487 N; 95% CI, 2393 to 2581) compared with exercise participants (2687 N; 95% CI, 2590 to 2784, pairwise difference [Δ](exercise vs diet )= 200 N; 95% CI, 55 to 345; P = .007). Concentrations of IL-6 were lower in diet + exercise (2.7 pg/mL; 95% CI, 2.5 to 3.0) and diet participants (2.7 pg/mL; 95% CI, 2.4 to 3.0) compared with exercise participants (3.1 pg/mL; 95% CI, 2.9 to 3.4; Δ(exercise vs diet + exercise) = 0.39 pg/mL; 95% CI, -0.03 to 0.81; P = .007; Δ(exercise vs diet )= 0.43 pg/mL; 95% CI, 0.01 to 0.85, P = .006). The diet + exercise group had less pain (3.6; 95% CI, 3.2 to 4.1) and better function (14.1; 95% CI, 12.6 to 15.6) than both the diet group (4.8; 95% CI, 4.3 to 5.2) and exercise group (4.7; 95% CI, 4.2 to 5.1, Δ(exercise vs diet + exercise) = 1.02; 95% CI, 0.33 to 1.71; P(pain) = .004; 18.4; 95% CI, 16.9 to 19.9; Δ(exercise vs diet + exercise), 4.29; 95% CI, 2.07 to 6.50; P(function )< .001). The diet + exercise group (44.7; 95% CI, 43.4 to 46.0) also had better physical health-related quality of life scores than the exercise group (41.9; 95% CI, 40.5 to 43.2; Δ(exercise vs diet + exercise) = -2.81; 95% CI, -4.76 to -0.86; P = .005). CONCLUSIONS AND RELEVANCE Among overweight and obese adults with knee OA, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group; those in the diet group had greater reductions in knee compressive force than those in the exercise group. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00381290.
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Affiliation(s)
- Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina 27109, USA.
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356
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Gerus P, Sartori M, Besier TF, Fregly BJ, Delp SL, Banks SA, Pandy MG, D'Lima DD, Lloyd DG. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces. J Biomech 2013; 46:2778-86. [PMID: 24074941 DOI: 10.1016/j.jbiomech.2013.09.005] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 07/25/2013] [Accepted: 09/05/2013] [Indexed: 11/19/2022]
Abstract
Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model.
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Affiliation(s)
- Pauline Gerus
- Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Southport, QLD, Australia.
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357
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Hast MW, Piazza SJ. Dual-joint modeling for estimation of total knee replacement contact forces during locomotion. J Biomech Eng 2013; 135:021013. [PMID: 23445058 DOI: 10.1115/1.4023320] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Model-based estimation of in vivo contact forces arising between components of a total knee replacement is challenging because such forces depend upon accurate modeling of muscles, tendons, ligaments, contact, and multibody dynamics. Here we describe an approach to solving this problem with results that are tested by comparison to knee loads measured in vivo for a single subject and made available through the Grand Challenge Competition to Predict in vivo Tibiofemoral Loads. The approach makes use of a "dual-joint" paradigm in which the knee joint is alternately represented by (1) a ball-joint knee for inverse dynamic computation of required muscle controls and (2) a 12 degree-of-freedom (DOF) knee with elastic foundation contact at the tibiofemoral and patellofemoral articulations for forward dynamic integration. Measured external forces and kinematics were applied as a feedback controller and static optimization attempted to track measured knee flexion angles and electromyographic (EMG) activity. The resulting simulations showed excellent tracking of knee flexion (average RMS error of 2.53 deg) and EMG (muscle activations within ±10% envelopes of normalized measured EMG signals). Simulated tibiofemoral contact forces agreed qualitatively with measured contact forces, but their RMS errors were approximately 25% of the peak measured values. These results demonstrate the potential of a dual-joint modeling approach to predict joint contact forces from kinesiological data measured in the motion laboratory. It is anticipated that errors in the estimation of contact force will be reduced as more accurate subject-specific models of muscles and other soft tissues are developed.
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Affiliation(s)
- Michael W Hast
- Department of Mechanical and Nuclear Engineering, The Pennsylvania State University, University Park, PA 16802, USA
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358
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The effects of walking speed on tibiofemoral loading estimated via musculoskeletal modeling. J Appl Biomech 2013; 30:197-205. [PMID: 23878264 DOI: 10.1123/jab.2012-0206] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Net muscle moments (NMMs) have been used as proxy measures of joint loading, but musculoskeletal models can estimate contact forces within joints. The purpose of this study was to use a musculoskeletal model to estimate tibiofemoral forces and to examine the relationship between NMMs and tibiofemoral forces across walking speeds. We collected kinematic, kinetic, and electromyographic data as ten adult participants walked on a dual-belt force-measuring treadmill at 0.75, 1.25, and 1.50 m/s. We scaled a musculoskeletal model to each participant and used OpenSim to calculate the NMMs and muscle forces through inverse dynamics and weighted static optimization, respectively. We determined tibiofemoral forces from the vector sum of intersegmental and muscle forces crossing the knee. Estimated tibiofemoral forces increased with walking speed. Peak early-stance compressive tibiofemoral forces increased 52% as walking speed increased from 0.75 to 1.50 m/s, whereas peak knee extension NMMs increased by 168%. During late stance, peak compressive tibiofemoral forces increased by 18% as speed increased. Although compressive loads at the knee did not increase in direct proportion to NMMs, faster walking resulted in greater compressive forces during weight acceptance and increased compressive and anterior/posterior tibiofemoral loading rates in addition to a greater abduction NMM.
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359
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Messier SP, Mihalko SL, Beavers DP, Nicklas BJ, DeVita P, Carr JJ, Hunter DJ, Williamson JD, Bennell KL, Guermazi A, Lyles M, Loeser RF. Strength Training for Arthritis Trial (START): design and rationale. BMC Musculoskelet Disord 2013; 14:208. [PMID: 23855596 PMCID: PMC3722013 DOI: 10.1186/1471-2474-14-208] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 06/11/2013] [Indexed: 12/12/2022] Open
Abstract
Background Muscle loss and fat gain contribute to the disability, pain, and morbidity associated with knee osteoarthritis (OA), and thigh muscle weakness is an independent and modifiable risk factor for it. However, while all published treatment guidelines recommend muscle strengthening exercise to combat loss of muscle mass and strength in knee OA patients, previous strength training studies either used intensities or loads below recommended levels for healthy adults or were generally short, lasting only 6 to 24 weeks. The efficacy of high-intensity strength training in improving OA symptoms, slowing progression, and affecting the underlying mechanisms has not been examined due to the unsubstantiated belief that it might exacerbate symptoms. We hypothesize that in addition to short-term clinical benefits, combining greater duration with high-intensity strength training will alter thigh composition sufficiently to attain long-term reductions in knee-joint forces, lower pain levels, decrease inflammatory cytokines, and slow OA progression. Methods/Design This is an assessor-blind, randomized controlled trial. The study population consists of 372 older (age ≥ 55 yrs) ambulatory, community-dwelling persons with: (1) mild-to-moderate medial tibiofemoral OA (Kellgren-Lawrence (KL) = 2 or 3); (2) knee neutral or varus aligned knee ( -2° valgus ≤ angle ≤ 10° varus); (3) 20 kg.m-2 ≥ BMI ≤ 45 kg.m-2; and (3) no participation in a formal strength-training program for more than 30 minutes per week within the past 6 months. Participants are randomized to one of 3 groups: high-intensity strength training (75-90% 1Repetition Maximum (1RM)); low-intensity strength training (30-40%1RM); or healthy living education. The primary clinical aim is to compare the interventions’ effects on knee pain, and the primary mechanistic aim is to compare their effects on knee-joint compressive forces during walking, a mechanism that affects the OA disease pathway. Secondary aims will compare the interventions’ effects on additional clinical measures of disease severity (e.g., function, mobility); disease progression measured by x-ray; thigh muscle and fat volume, measured by computed tomography (CT); components of thigh muscle function, including hip abductor strength and quadriceps strength, and power; additional measures of knee-joint loading; inflammatory and OA biomarkers; and health-related quality of life. Discussion Test-retest reliability for the thigh CT scan was: total thigh volume, intra-class correlation coefficients (ICC) = 0.99; total fat volume, ICC = 0.99, and total muscle volume, ICC = 0.99. ICC for both isokinetic concentric knee flexion and extension strength was 0.93, and for hip-abductor concentric strength was 0.99. The reliability of our 1RM testing was: leg press, ICC = 0.95; leg curl, ICC = 0.99; and leg extension, ICC = 0.98. Results of this trial will provide critically needed guidance for clinicians in a variety of health professions who prescribe and oversee treatment and prevention of OA-related complications. Given the prevalence and impact of OA and the widespread availability of this intervention, assessing the efficacy of optimal strength training has the potential for immediate and vital clinical impact. Trial registration ClinicalTrials.gov, NCT01489462
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360
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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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361
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Sartori M, Gizzi L, Lloyd DG, Farina D. A musculoskeletal model of human locomotion driven by a low dimensional set of impulsive excitation primitives. Front Comput Neurosci 2013; 7:79. [PMID: 23805099 PMCID: PMC3693080 DOI: 10.3389/fncom.2013.00079] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 06/02/2013] [Indexed: 12/01/2022] Open
Abstract
Human locomotion has been described as being generated by an impulsive (burst-like) excitation of groups of musculotendon units, with timing dependent on the biomechanical goal of the task. Despite this view being supported by many experimental observations on specific locomotion tasks, it is still unknown if the same impulsive controller (i.e., a low-dimensional set of time-delayed excitastion primitives) can be used as input drive for large musculoskeletal models across different human locomotion tasks. For this purpose, we extracted, with non-negative matrix factorization, five non-negative factors from a large sample of muscle electromyograms in two healthy subjects during four motor tasks. These included walking, running, sidestepping, and crossover cutting maneuvers. The extracted non-negative factors were then averaged and parameterized to obtain task-generic Gaussian-shaped impulsive excitation curves or primitives. These were used to drive a subject-specific musculoskeletal model of the human lower extremity. Results showed that the same set of five impulsive excitation primitives could be used to predict the dynamics of 34 musculotendon units and the resulting hip, knee and ankle joint moments (i.e., NRMSE = 0.18 ± 0.08, and R2 = 0.73 ± 0.22 across all tasks and subjects) without substantial loss of accuracy with respect to using experimental electromyograms (i.e., NRMSE = 0.16 ± 0.07, and R2 = 0.78 ± 0.18 across all tasks and subjects). Results support the hypothesis that biomechanically different motor tasks might share similar neuromuscular control strategies. This might have implications in neurorehabilitation technologies such as human-machine interfaces for the torque-driven, proportional control of powered prostheses and orthoses. In this, device control commands (i.e., predicted joint torque) could be derived without direct experimental data but relying on simple parameterized Gaussian-shaped curves, thus decreasing the input drive complexity and the number of needed sensors.
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Affiliation(s)
- Massimo Sartori
- Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen, University Medical Center Göttingen Göttingen, Germany
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362
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Wagner DW, Stepanyan V, Shippen JM, Demers MS, Gibbons RS, Andrews BJ, Creasey GH, Beaupre GS. Consistency among musculoskeletal models: caveat utilitor. Ann Biomed Eng 2013; 41:1787-99. [PMID: 23775441 DOI: 10.1007/s10439-013-0843-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/05/2013] [Indexed: 10/26/2022]
Abstract
Musculoskeletal simulation software and model repositories have broadened the user base able to perform musculoskeletal analysis and have facilitated in the sharing of models. As the recognition of musculoskeletal modeling continues to grow as an engineering discipline, the consistency in results derived from different models and software is becoming more critical. The purpose of this study was to compare eight models from three software packages and evaluate differences in quadriceps moment arms, predicted muscle forces, and predicted tibiofemoral contact forces for an idealized knee-extension task spanning -125 to +10° of knee extension. Substantial variation among models was observed for the majority of aspects evaluated. Differences among models were influenced by knee angle, with better agreement of moment arms and tibiofemoral joint contact force occurring at low to moderate knee flexion angles. The results suggest a lack of consistency among models and that output differences are not simply an artifact of naturally occurring inter-individual differences. Although generic musculoskeletal models can easily be scaled to consistent limb lengths and use the same muscle recruitment algorithm, the results suggest those are not sufficient conditions to produce consistent muscle or joint contact forces, even for simplified models with no potential of co-contraction.
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Affiliation(s)
- David W Wagner
- Center for Tissue Regeneration, Repair, and Restoration, VA Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA 94304, USA.
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363
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Meyer AJ, D'Lima DD, Besier TF, Lloyd DG, Colwell CW, Fregly BJ. Are external knee load and EMG measures accurate indicators of internal knee contact forces during gait? J Orthop Res 2013; 31:921-9. [PMID: 23280647 PMCID: PMC3628973 DOI: 10.1002/jor.22304] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 12/06/2012] [Indexed: 02/04/2023]
Abstract
Mechanical loading is believed to be a critical factor in the development and treatment of knee osteoarthritis. However, the contact forces to which the knee articular surfaces are subjected during daily activities cannot be measured clinically. Thus, the ability to predict internal knee contact forces accurately using external measures (i.e., external knee loads and muscle electromyographic [EMG] signals) would be clinically valuable. We quantified how well external knee load and EMG measures predict internal knee contact forces during gait. A single subject with a force-measuring tibial prosthesis and post-operative valgus alignment performed four gait patterns (normal, medial thrust, walking pole, and trunk sway) to induce a wide range of external and internal knee joint loads. Linear regression analyses were performed to assess how much of the variability in internal contact forces was accounted for by variability in the external measures. Though the different gait patterns successfully induced significant changes in the external and internal quantities, changes in external measures were generally weak indicators of changes in total, medial, and lateral contact force. Our results suggest that when total contact force may be changing, caution should be exercised when inferring changes in knee contact forces based on observed changes in external knee load and EMG measures. Advances in musculoskeletal modeling methods may be needed for accurate estimation of in vivo knee contact forces.
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Affiliation(s)
- Andrew J. Meyer
- Dept. of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL
| | - Darryl D. D'Lima
- Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA
| | - Thor F. Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - David G. Lloyd
- Griffith Health Institute, Griffith University, Queensland, Australia
| | - Clifford W. Colwell
- Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA
| | - Benjamin J. Fregly
- Dept. of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL,Dept. of Biomedical Engineering, University of Florida, Gainesville, FL,Dept. of Orthopaedics & Rehabilitation, University of Florida, Gainesville, FL
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364
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Pegg E, Walter J, Mellon S, Pandit H, Murray D, D'Lima D, Fregly B, Gill H. Evaluation of factors affecting tibial bone strain after unicompartmental knee replacement. J Orthop Res 2013. [PMID: 23192787 PMCID: PMC3602347 DOI: 10.1002/jor.22283] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Persistent pain is an important cause of patient dissatisfaction after unicompartmental knee replacement (UKR) and has been correlated with localized tibial strain. However, the factors that influence these strains are not well understood. To address this issue, we created finite element models to examine the effect on tibial strain of: (1) muscle forces (estimated using instrumented knee data) acting on attachment sites on the proximal tibia, (2) UKR implantation, (3) loading position, and (4) changes in gait pattern. Muscle forces acting on the tibia had no significant influence on strains within the periprosthetic region, but UKR implantation increased strain by 20%. Strain also significantly increased if the region of load application was moved >3 mm medially. The strain within the periprosthetic region was found to be dependent on gait pattern and was influenced by both medial and lateral loads, with the medial load having a greater effect (regression coefficients: medial = 0.74, lateral = 0.30). These findings suggest that tibial strain is increased after UKR and may be a cause of pain. It may be possible to reduce pain through modification of surgical factors or through altered gait patterns.
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Affiliation(s)
- E.C Pegg
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Oxford, UK
| | - J. Walter
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USA
| | - S.J. Mellon
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Oxford, UK
| | - H.G. Pandit
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Oxford, UK
| | - D.W. Murray
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Oxford, UK
| | - D.D. D'Lima
- Shiley Center for Orthopaedic Research & Education, Scripps Clinic, La Jolla, CA, USA
| | - B.J. Fregly
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USA
| | - H.S. Gill
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Oxford, UK
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365
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Kim W, Espanha MM, Veloso AP, Araújo D, João F, Carrão L, Kohles SS. An Informational Algorithm as the Basis for Perception-Action Control of the Instantaneous Axes of the Knee. JOURNAL OF NOVEL PHYSIOTHERAPIES 2013; 3:127. [PMID: 24932433 PMCID: PMC4057049 DOI: 10.4172/2165-7025.1000127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Traditional locomotion studies emphasize an optimization of the desired movement trajectories while ignoring sensory feedback. We propose an information based theory that locomotion is neither triggered nor commanded but controlled. The basis for this control is the information derived from perceiving oneself in the world. Control therefore lies in the human-environment system. In order to test this hypothesis, we derived a mathematical foundation characterizing the energy that is required to perform a rotational twist, with small amplitude, of the instantaneous axes of the knee (IAK). We have found that the joint’s perception of the ground reaction force may be replaced by the co-perception of muscle activation with appropriate intensities. This approach generated an accurate comparison with known joint forces and appears appropriate in so far as predicting the effect on the knee when it is free to twist about the IAK.
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Affiliation(s)
- Wangdo Kim
- Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002 Lisbon, Portugal
| | - Margarida M Espanha
- Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002 Lisbon, Portugal
| | - António P Veloso
- Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002 Lisbon, Portugal
| | - Duarte Araújo
- Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002 Lisbon, Portugal
| | - Filipa João
- Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002 Lisbon, Portugal
| | - Luis Carrão
- Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF, SPERTLAB, Estrada da Costa, P-1499-002 Lisbon, Portugal
| | - Sean S Kohles
- Regenerative Bioengineering Laboratory, Departments of Mechanical and Materials Engineering and Biology, Portland State University, Portland, Oregon, USA
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366
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Kim W, Kim YH, Veloso AP, Kohles SS. Tracking Knee Joint Functional Axes through Tikhonov Filtering and Plűcker Coordinates. JOURNAL OF NOVEL PHYSIOTHERAPIES 2013; Suppl 4. [PMID: 23720709 DOI: 10.4172/2165-7025.s4-001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Researchers have reported several compensation methods to estimate bone and joint position from a cluster of skin-mounted markers as influenced by Soft Tissue Artifacts (STA). Tikhonov Regularization Filtering (TRF) as a means to estimate Instantaneous Screw Axes (ISA) was introduced here as a means to reduce the displacement of a rigid body to its simplest geometric form. Recent studies have suggested that the ISA of the knee, i.e., Knee Functional Axes (KFA), might be closely connected to the estimation of constraint forces such as those due to medial and lateral connective tissues. The estimations of ISAs were known to be highly sensitive to noisy data, which may be mathematically ill-posed, requiring smoothing such as that conducted by regularization. The main contribution in this work was to establish the reciprocal connection between the KFA and Ground Reaction Forces (GRF) as a means to estimate joint constraint forces. Presented results compare the computational performance with published kinetic and kinematic joint data generated from an instrumented total knee replacement. Implications of these preliminary findings with respect to dynamic alignment as a functional anatomic metric are discussed.
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Affiliation(s)
- Wangdo Kim
- Univ Tecn Lisboa, Fac Motricidade Humana, CIPER, LBMF. Estrada da Costa, P-1499-002 Lisbon, Portugal
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367
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Kinney AL, Besier TF, Silder A, Delp SL, D’Lima DD, Fregly BJ. Changes in in vivo knee contact forces through gait modification. J Orthop Res 2013; 31:434-40. [PMID: 23027590 PMCID: PMC3553232 DOI: 10.1002/jor.22240] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 09/04/2012] [Indexed: 02/04/2023]
Abstract
Knee osteoarthritis (OA) commonly occurs in the medial compartment of the knee and has been linked to overloading of the medial articular cartilage. Gait modification represents a non-invasive treatment strategy for reducing medial compartment knee force. The purpose of this study was to evaluate the effectiveness of a variety of gait modifications that were expected to alter medial contact force. A single subject implanted with a force-measuring knee replacement walked using nine modified gait patterns, four of which involved different hiking pole configurations. Medial and lateral contact force at 25, 50, and 75% of stance phase, and the average value over all of stance phase (0-100%), were determined for each gait pattern. Changes in medial and lateral contact force values relative to the subject's normal gait pattern were determined by a Kruskal-Wallis test. Apart from early stance (25% of stance), medial contact force was most effectively reduced by walking with long hiking poles and wide pole placement, which significantly reduced medial and lateral contact force during stance phase by up to 34% (at 75% of stance) and 26% (at 50% of stance), respectively. Although this study is based on data from a single subject, the results provide important insight into changes in medial and lateral contact forces through gait modification. The results of this study suggest that an optimal configuration of bilateral hiking poles may significantly reduce both medial and lateral compartment knee forces in individuals with medial knee osteoarthritis.
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Affiliation(s)
- Allison L. Kinney
- Dept. of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USA
| | - Thor F. Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Amy Silder
- Dept. of Bioengineering, Stanford University, Stanford, CA, USA,Dept. of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Scott L. Delp
- Dept. of Bioengineering, Stanford University, Stanford, CA, USA,Dept. of Orthopaedic Surgery, Stanford University, Stanford, CA, USA,Dept. of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Darryl D. D’Lima
- Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA
| | - Benjamin J. Fregly
- Dept. of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USA,Dept. of Biomedical Engineering, University of Florida, Gainesville, FL, USA,Dept. of Orthopaedics & Rehabilitation, University of Florida, Gainesville, FL, USA
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368
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Modenese L, Gopalakrishnan A, Phillips ATM. Application of a falsification strategy to a musculoskeletal model of the lower limb and accuracy of the predicted hip contact force vector. J Biomech 2013; 46:1193-200. [PMID: 23427941 DOI: 10.1016/j.jbiomech.2012.11.045] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 11/22/2012] [Accepted: 11/25/2012] [Indexed: 12/01/2022]
Abstract
In the literature, lower limb musculoskeletal models validated against in vivo measured hip contact forces (HCFs) exhibit a tendency to overestimate the HCFs magnitude and predict inaccurate components of the HCF vector in the transverse plane. In order to investigate this issue, a musculoskeletal model was forced to produce HCFs identical to those measured and the resulting joint equilibrium equations were studied through both a general approach and a static optimization framework. In the former case, the existence of solutions to the equilibrium equations was investigated and the effect of varying the intersegmental moments and the muscle tetanic stress assessed: for a value of 100 N/cm(2) and moments calculated from an inverse dynamics analysis on average only 62% of analyzed frames were solvable for level walking and 70% for stair climbing. In the static optimization study, the model could reproduce the experimental HCFs but the recruited muscles were unable to simultaneously equilibrate the hip intersegmental moments without the contribution of reserve moment actuators. Without constraints imposed on the HCFs, the predicted HCF vectors presented maximum angle deviations up to 22° for level walking and 33° for stair climbing during the gait stance phase. The influence of the medio-lateral HCF component on the solvability of the equilibrium equations and the muscle recruitment alteration when the model was forced to produce the experimental HCFs suggest that a more accurate geometrical representation of the gluteal muscles is mandatory to improve predictions of the HCF vector yielded by the static optimization technique.
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Affiliation(s)
- L Modenese
- Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College London, UK.
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369
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Recent advances in computational mechanics of the human knee joint. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2013; 2013:718423. [PMID: 23509602 PMCID: PMC3590578 DOI: 10.1155/2013/718423] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 11/21/2012] [Accepted: 12/20/2012] [Indexed: 11/18/2022]
Abstract
Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.
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370
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Lundberg HJ, Knowlton C, Wimmer MA. Fine tuning total knee replacement contact force prediction algorithms using blinded model validation. J Biomech Eng 2013; 135:021015. [PMID: 23445060 PMCID: PMC3627216 DOI: 10.1115/1.4023388] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 01/07/2013] [Accepted: 01/18/2013] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to perform a blinded comparison of model predictions of total knee replacement contact forces to in vivo forces from an instrumented prosthesis during normal walking and medial thrust gait by participating in the "Third Grand Challenge Competition to Predict in vivo Knee Loads." We also evaluated model assumptions that were critical for accurate force predictions. Medial, lateral, and total axial forces through the knee were calculated using a previously developed and validated parametric numerical model. The model uses equilibrium equations between internal and external moments and forces to obtain knee joint contact forces and calculates a range of forces at instances during the gait cycle through parametric variation of muscle activity levels. For 100 instances during a normal over-ground gait cycle, model root mean square differences from eTibia data were 292, 248, and 281 for medial, lateral, and total contact forces, respectively. For 100 instances during a medial thrust gait cycle, model root mean square differences from eTibia data were 332, 234, and 470 for medial, lateral, and total contact forces, respectively. The percent difference between measured and predicted peak total axial force was 2.89% at the first peak and 9.36% at the second peak contact force for normal walking and 3.94% at the first peak and 14.86% at the second peak contact force for medial thrust gait. After unblinding, changes to model assumptions improved medial and lateral force predictions for both gait styles but did not improve total force predictions. Axial forces computed with the model compared well to the eTibia data under blinded and unblinded conditions. Knowledge of detailed knee kinematics, namely anterior-posterior translation, appears to be critical in obtaining accurate force predictions.
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Affiliation(s)
- Hannah J Lundberg
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 West Harrison, Chicago, IL 60612, USA.
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371
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Kinney AL, Besier TF, D'Lima DD, Fregly BJ. Update on grand challenge competition to predict in vivo knee loads. J Biomech Eng 2013; 135:021012. [PMID: 23445057 PMCID: PMC3597120 DOI: 10.1115/1.4023255] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 12/18/2012] [Accepted: 12/26/2012] [Indexed: 11/08/2022]
Abstract
Validation is critical if clinicians are to use musculoskeletal models to optimize treatment of individual patients with a variety of musculoskeletal disorders. This paper provides an update on the annual Grand Challenge Competition to Predict in Vivo Knee Loads, a unique opportunity for direct validation of knee contact forces and indirect validation of knee muscle forces predicted by musculoskeletal models. Three competitions (2010, 2011, and 2012) have been held at the annual American Society of Mechanical Engineers Summer Bioengineering Conference, and two more competitions are planned for the 2013 and 2014 conferences. Each year of the competition, a comprehensive data set collected from a single subject implanted with a force-measuring knee replacement is released. Competitors predict medial and lateral knee contact forces for two gait trials without knowledge of the experimental knee contact force measurements. Predictions are evaluated by calculating root-mean-square (RMS) errors and R(2) values relative to the experimentally measured medial and lateral contact forces. For the first three years of the competition, competitors used a variety of methods to predict knee contact and muscle forces, including static and dynamic optimization, EMG-driven models, and parametric numerical models. Overall, errors in predicted contact forces were comparable across years, with average RMS errors for the four competition winners ranging from 229 N to 312 N for medial contact force and from 238 N to 326 N for lateral contact force. Competitors generally predicted variations in medial contact force (highest R(2 )= 0.91) better than variations in lateral contact force (highest R(2 )= 0.70). Thus, significant room for improvement exists in the remaining two competitions. The entire musculoskeletal modeling community is encouraged to use the competition data and models for their own model validation efforts.
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Affiliation(s)
- Allison L. Kinney
- Department of Mechanical and Aerospace Engineering,University of Florida,Gainesville, FL 32611
| | - Thor F. Besier
- Auckland Bioengineering Institute,University of Auckland,Auckland 1142, New Zealand
| | - Darryl D. D'Lima
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic,La Jolla, CA 92037
| | - Benjamin J. Fregly
- Department of Mechanical and Aerospace Engineering,University of Florida,Gainesville, FL 32611;Department of Biomedical Engineering,University of Florida,Gainesville, FL 32611;Department of Orthopaedics and Rehabilitation,University of Florida, Gainesville, FL 32611e-mail:
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372
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Henak CR, Anderson AE, Weiss JA. Subject-specific analysis of joint contact mechanics: application to the study of osteoarthritis and surgical planning. J Biomech Eng 2013; 135:021003. [PMID: 23445048 PMCID: PMC3705883 DOI: 10.1115/1.4023386] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/03/2013] [Accepted: 01/18/2013] [Indexed: 11/08/2022]
Abstract
Advances in computational mechanics, constitutive modeling, and techniques for subject-specific modeling have opened the door to patient-specific simulation of the relationships between joint mechanics and osteoarthritis (OA), as well as patient-specific preoperative planning. This article reviews the application of computational biomechanics to the simulation of joint contact mechanics as relevant to the study of OA. This review begins with background regarding OA and the mechanical causes of OA in the context of simulations of joint mechanics. The broad range of technical considerations in creating validated subject-specific whole joint models is discussed. The types of computational models available for the study of joint mechanics are reviewed. The types of constitutive models that are available for articular cartilage are reviewed, with special attention to choosing an appropriate constitutive model for the application at hand. Issues related to model generation are discussed, including acquisition of model geometry from volumetric image data and specific considerations for acquisition of computed tomography and magnetic resonance imaging data. Approaches to model validation are reviewed. The areas of parametric analysis, factorial design, and probabilistic analysis are reviewed in the context of simulations of joint contact mechanics. Following the review of technical considerations, the article details insights that have been obtained from computational models of joint mechanics for normal joints; patient populations; the study of specific aspects of joint mechanics relevant to OA, such as congruency and instability; and preoperative planning. Finally, future directions for research and application are summarized.
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Affiliation(s)
- Corinne R. Henak
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84112;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84112
| | - Andrew E. Anderson
- Department of Bioengineering,University of Utah,Salt Lake City, UT;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108;Department of Physical Therapy,University of Utah,Salt Lake City, UT 84108
| | - Jeffrey A. Weiss
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84108;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84108;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108e-mail:
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373
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D'Lima DD, Fregly BJ, Colwell CW. Implantable sensor technology: measuring bone and joint biomechanics of daily life in vivo. Arthritis Res Ther 2013; 15:203. [PMID: 23369655 PMCID: PMC3672791 DOI: 10.1186/ar4138] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Stresses and strains are major factors influencing growth, remodeling and repair of musculoskeletal tissues. Therefore, knowledge of forces and deformation within bones and joints is critical to gain insight into the complex behavior of these tissues during development, aging, and response to injury and disease. Sensors have been used in vivo to measure strains in bone, intraarticular cartilage contact pressures, and forces in the spine, shoulder, hip, and knee. Implantable sensors have a high impact on several clinical applications, including fracture fixation, spine fixation, and joint arthroplasty. This review summarizes the developments in strain-measurement-based implantable sensor technology for musculoskeletal research.
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Affiliation(s)
- Darryl D D'Lima
- Scripps Health, Shiley Center for Orthopaedic Research and Education at Scripps Clinic, 11025 North Torrey Pines Road, Suite 200, La Jolla, CA 92037-1030, USA
| | - Benjamin J Fregly
- Department of Mechanical and Aerospace Engineering, 231 MAE-A Building, Box 116250, University of Florida, Gainesville, FL 32611-6520, USA
| | - Clifford W Colwell
- Scripps Health, Shiley Center for Orthopaedic Research and Education at Scripps Clinic, 11025 North Torrey Pines Road, Suite 200, La Jolla, CA 92037-1030, USA
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374
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Chèze L, Moissenet F, Dumas R. State of the art and current limits of musculo-skeletal models for clinical applications. ACTA ACUST UNITED AC 2012. [DOI: 10.1051/sm/2012026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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375
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Ting LH, Chvatal SA, Safavynia SA, McKay JL. Review and perspective: neuromechanical considerations for predicting muscle activation patterns for movement. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2012; 28:1003-1014. [PMID: 23027631 PMCID: PMC4121429 DOI: 10.1002/cnm.2485] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 03/02/2012] [Accepted: 03/31/2012] [Indexed: 06/01/2023]
Abstract
Muscle coordination may be difficult or impossible to predict accurately based on biomechanical considerations alone because of redundancy in the musculoskeletal system. Because many solutions exist for any given movement, the role of the nervous system in further constraining muscle coordination patterns for movement must be considered in both healthy and impaired motor control. On the basis of computational neuromechanical analyses of experimental data combined with modeling techniques, we have demonstrated several such neural constraints on the temporal and spatial patterns of muscle activity during both locomotion and postural responses to balance perturbations. We hypothesize that subject-specific and trial-by-trial differences in muscle activation can be parameterized and understood by a hierarchical and low-dimensional framework that reflects the neural control of task-level goals. In postural control, we demonstrate that temporal patterns of muscle activity may be governed by feedback control of task-level variables that represent the overall goal-directed motion of the body. These temporal patterns then recruit spatially-fixed patterns of muscle activity called muscle synergies that produce the desired task-level biomechanical functions that require multijoint coordination. Moreover, these principles apply more generally to movement, and in particular to locomotor tasks in both healthy and impaired individuals. Overall, understanding the goals and organization of the neural control of movement may provide useful reduced dimension parameter sets to address the degrees-of-freedom problem in musculoskeletal movement control. More importantly, however, neuromechanical analyses may lend insight and provide a framework for understanding subject-specific and trial-by-trial differences in movement across both healthy and motor-impaired populations.
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Affiliation(s)
- Lena H Ting
- The Wallace H. Coulter Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, 313 Ferst Drive, Atlanta, GA 30332-0535, USA.
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376
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Abstract
Cartilage repair and restoration has become an increasingly popular surgical technique to provide symptomatic relief to young patients with focal articular cartilage defects. Given the high level of interest and improvement in surgical techniques to perform cartilage repair or restoration, it is important that patient-reported, surgical and functional outcomes are evaluated both in the short term and long term. Despite the high levels of interest in cartilage repair and restoration techniques, there are few studies that have evaluated the effects of cartilage surgery on biomechanical and neuromuscular function of the joint and the lower extremity. The focus of the following review is to evaluate the current evidence available on biomechanical functional outcomes after cartilage repair with clinical applications to the rehabilitation process.
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Affiliation(s)
- Carmen E. Quatman
- Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio,Department of Orthopaedics, The Ohio State University, Columbus, Ohio
| | - Joshua D. Harris
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio
| | - Timothy E. Hewett
- Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio,Department of Orthopaedics, The Ohio State University, Columbus, Ohio,Sports Medicine Biodynamics Center Cincinnati Children's Hospital, Cincinnati, Ohio,Departments of Physiology and Cell Biology, Family Medicine, and Biomedical Engineering, The Ohio State University, Columbus, Ohio
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377
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Moissenet F, Chèze L, Dumas R. Potential of the Pseudo-Inverse Method as a Constrained Static Optimization for Musculo-Tendon Forces Prediction. J Biomech Eng 2012; 134:064503. [DOI: 10.1115/1.4006900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inverse dynamics combined with a constrained static optimization analysis has often been proposed to solve the muscular redundancy problem. Typically, the optimization problem consists in a cost function to be minimized and some equality and inequality constraints to be fulfilled. Penalty-based and Lagrange multipliers methods are common optimization methods for the equality constraints management. More recently, the pseudo-inverse method has been introduced in the field of biomechanics. The purpose of this paper is to evaluate the ability and the efficiency of this new method to solve the muscular redundancy problem, by comparing respectively the musculo-tendon forces prediction and its cost-effectiveness against common optimization methods. Since algorithm efficiency and equality constraints fulfillment highly belong to the optimization method, a two-phase procedure is proposed in order to identify and compare the complexity of the cost function, the number of iterations needed to find a solution and the computational time of the penalty-based method, the Lagrange multipliers method and pseudo-inverse method. Using a 2D knee musculo-skeletal model in an isometric context, the study of the cost functions isovalue curves shows that the solution space is 2D with the penalty-based method, 3D with the Lagrange multipliers method and 1D with the pseudo-inverse method. The minimal cost function area (defined as the area corresponding to 5% over the minimal cost) obtained for the pseudo-inverse method is very limited and along the solution space line, whereas the minimal cost function area obtained for other methods are larger or more complex. Moreover, when using a 3D lower limb musculo-skeletal model during a gait cycle simulation, the pseudo-inverse method provides the lowest number of iterations while Lagrange multipliers and pseudo-inverse method have almost the same computational time. The pseudo-inverse method, by providing a better suited cost function and an efficient computational framework, seems to be adapted to the muscular redundancy problem resolution in case of linear equality constraints. Moreover, by reducing the solution space, this method could be a unique opportunity to introduce optimization methods for a posteriori articulation of preference in order to provide a palette of solutions rather than a unique solution based on a lot of hypotheses.
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Affiliation(s)
- Florent Moissenet
- Rehazenter, Laboratoire d’Analyse du Mouvement et la Posture, 1 rue André Vésale, L-2674 Luxembourg, Luxembourg
| | - Laurence Chèze
- Université de Lyon, F-69622 Lyon, France; Laboratoire de Biomécanique et Mécanique des Chocs, UMR_T9406; Université Lyon 1, Villeurbanne;IFSTTAR, Bron
| | - Raphaël Dumas
- Université de Lyon, F-69622 Lyon, France; Laboratoire de Biomécanique et Mécanique des Chocs, UMR_T9406; Université Lyon 1, Villeurbanne;IFSTTAR, Bron
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378
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Halloran JP, Sibole S, van Donkelaar CC, van Turnhout MC, Oomens CWJ, Weiss JA, Guilak F, Erdemir A. Multiscale mechanics of articular cartilage: potentials and challenges of coupling musculoskeletal, joint, and microscale computational models. Ann Biomed Eng 2012; 40:2456-74. [PMID: 22648577 DOI: 10.1007/s10439-012-0598-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 05/16/2012] [Indexed: 11/27/2022]
Abstract
Articular cartilage experiences significant mechanical loads during daily activities. Healthy cartilage provides the capacity for load bearing and regulates the mechanobiological processes for tissue development, maintenance, and repair. Experimental studies at multiple scales have provided a fundamental understanding of macroscopic mechanical function, evaluation of the micromechanical environment of chondrocytes, and the foundations for mechanobiological response. In addition, computational models of cartilage have offered a concise description of experimental data at many spatial levels under healthy and diseased conditions, and have served to generate hypotheses for the mechanical and biological function. Further, modeling and simulation provides a platform for predictive risk assessment, management of dysfunction, as well as a means to relate multiple spatial scales. Simulation-based investigation of cartilage comes with many challenges including both the computational burden and often insufficient availability of data for model development and validation. This review outlines recent modeling and simulation approaches to understand cartilage function from a mechanical systems perspective, and illustrates pathways to associate mechanics with biological function. Computational representations at single scales are provided from the body down to the microstructure, along with attempts to explore multiscale mechanisms of load sharing that dictate the mechanical environment of the cartilage and chondrocytes.
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Affiliation(s)
- J P Halloran
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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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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