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Valente G, Benedetti MG, De Paolis M, Donati DM, Taddei F. Differences in hip musculoskeletal loads between limbs during daily activities in patients with 3D-printed hemipelvic reconstructions following tumor surgery. Gait Posture 2023; 102:56-63. [PMID: 36924596 DOI: 10.1016/j.gaitpost.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Anatomical custom-made prostheses, thanks to computer-aided design and 3D-printing technology, help improve osseointegration and reduce mechanical complications in bone reconstructions following bone tumors. A recent quantitative analysis of long-term recovery in patients with 3D-printed reconstructions following pelvic tumor surgery showed asymmetries in ground reaction forces between limbs during different motor activities, while standing very good motor performance and quality of life. RESEARCH QUESTION We analyzed hip contact forces and muscle forces in that cohort of six patients with an innovative custom-made reconstruction of the hemipelvis, and we tested the hypothesis that asymmetries in ground reaction forces would result in more marked differences in musculoskeletal forces. METHODS State-of-the-art musculoskeletal modeling in an optimization-based inverse-dynamics workflow was used to calculate hip contact forces and muscle forces during five motor activities, and the differences between limbs were statistically evaluated across the motor activity cycles and on the force peaks. RESULTS The musculoskeletal loads were found to be not symmetric, as hip loads were generally higher in the contralateral limb. We found significant differences in considerable portions of the motor activities cycles except squat, load symmetry indices indicating a load increase (median up to 25%) on the contralateral limb, especially during stair descent and chair rise/sit, and significantly higher values in the contralateral limb at force peaks. SIGNIFICANCE We confirmed the hypothesis that residual asymmetries found in ground reaction forces were amplified when hip musculoskeletal loads were investigated, reflecting a shift of the loads toward the intact limb. Despite the general trend of higher loads found in the contralateral hip, this cannot be considered a risk of overloading, as both hips supported loads in a physiological range or lower, indicating a likely optimal recovery.
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Affiliation(s)
- Giordano Valente
- Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Massimiliano De Paolis
- Department of Orthopaedics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Fulvia Taddei
- Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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2
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Makani A, Shirazi-Adl SA, Ghezelbash F. Computational biomechanics of human knee joint in stair ascent: Muscle-ligament-contact forces and comparison with level walking. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3646. [PMID: 36054682 DOI: 10.1002/cnm.3646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/28/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
About a third of knee joint disorders originate from the patellofemoral (PF) site that makes stair ascent a difficult activity for patients. A detailed finite element model of the knee joint is coupled to a lower extremity musculoskeletal model to simulate the stance phase of stair ascent. It is driven by the mean of measurements on the hip-knee-ankle moments-angles as well as ground reaction forces reported in healthy individuals. Predicted muscle activities compare well to the recorded electromyography data. Peak forces in quadriceps (3.87 BW, body weight, at 20% instance in our 607 N subject), medial hamstrings (0.77 BW at 20%), and gastrocnemii (1.21 BW at 80%) are estimated. Due to much greater flexion angles-moments in the first half of stance, large PF contact forces (peak of 3.1 BW at 20% stance) and stresses (peak of 4.83 MPa at 20% stance) are estimated that exceed their peaks in level walking by fourfold and twofold, respectively. Compared with level walking, ACL forces diminish in the first half of stance but substantially increase later in the second half (peak of 0.76 BW at 75% stance). Under nearly similar contact forces at 20% of stance, the contact stress on the tibiofemoral (TF) medial plateau reaches a peak (9.68 MPa) twice that on the PF joint suggesting the vulnerability of both joints. Compared with walking, stair ascent increases peak ACL force and both peak TF and PF contact stresses. Reductions in the knee flexion moment and/or angle appear as a viable strategy to mitigate internal loads and pain.
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Affiliation(s)
- Amirhossein Makani
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, Québec, Canada
| | - Saeed A Shirazi-Adl
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, Québec, Canada
| | - Farshid Ghezelbash
- Department of Mechanical Engineering, Polytechnique Montréal, Montreal, Québec, Canada
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3
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Modeling Musculoskeletal Dynamics during Gait: Evaluating the Best Personalization Strategy through Model Anatomical Consistency. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11188348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
No consensus exists on how to model human articulations within MSK models for the analysis of gait dynamics. We propose a method to evaluate joint models and we apply it to three models with different levels of personalization. The method evaluates the joint model’s adherence to the MSK hypothesis of negligible joint work by quantifying ligament and cartilage deformations resulting from joint motion; to be anatomically consistent, these deformations should be minimum. The contrary would require considerable external work to move the joint, violating a strong working hypothesis and raising concerns about the credibility of the MSK outputs. Gait analysis and medical resonance imaging (MRI) from ten participants were combined to build lower limb subject-specific MSK models. MRI-reconstructed anatomy enabled three levels of personalization using different ankle joint models, in which motion corresponded to different ligament elongation and cartilage co-penetration. To estimate the impact of anatomical inconsistency in MSK outputs, joint internal forces resulting from tissue deformations were computed for each joint model and MSK simulations were performed ignoring or considering their contribution. The three models differed considerably for maximum ligament elongation and cartilage co-penetration (between 5.94 and 50.69% and between −0.53 and −5.36 mm, respectively). However, the model dynamic output from the gait simulations were similar. When accounting for the internal forces associated with tissue deformation, outputs changed considerably, the higher the personalization level the smaller the changes. Anatomical consistency provides a solid method to compare different joint models. Results suggest that consistency grows with personalization, which should be tailored according to the research question. A high level of anatomical consistency is recommended when individual specificity and the behavior of articular structures is under investigation.
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De Roeck J, Duquesne K, Van Houcke J, Audenaert EA. Statistical-Shape Prediction of Lower Limb Kinematics During Cycling, Squatting, Lunging, and Stepping-Are Bone Geometry Predictors Helpful? Front Bioeng Biotechnol 2021; 9:696360. [PMID: 34322479 PMCID: PMC8312572 DOI: 10.3389/fbioe.2021.696360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Statistical shape methods have proven to be useful tools in providing statistical predications of several clinical and biomechanical features as to analyze and describe the possible link with them. In the present study, we aimed to explore and quantify the relationship between biometric features derived from imaging data and model-derived kinematics. Methods: Fifty-seven healthy males were gathered under strict exclusion criteria to ensure a sample representative of normal physiological conditions. MRI-based bone geometry was established and subject-specific musculoskeletal simulations in the Anybody Modeling System enabled us to derive personalized kinematics. Kinematic and shape findings were parameterized using principal component analysis. Partial least squares regression and canonical correlation analysis were then performed with the goal of predicting motion and exploring the possible association, respectively, with the given bone geometry. The relationship of hip flexion, abduction, and rotation, knee flexion, and ankle flexion with a subset of biometric features (age, length, and weight) was also investigated. Results: In the statistical kinematic models, mean accuracy errors ranged from 1.60° (race cycling) up to 3.10° (lunge). When imposing averaged kinematic waveforms, the reconstruction errors varied between 4.59° (step up) and 6.61° (lunge). A weak, yet clinical irrelevant, correlation between the modes describing bone geometry and kinematics was observed. Partial least square regression led to a minimal error reduction up to 0.42° compared to imposing gender-specific reference curves. The relationship between motion and the subject characteristics was even less pronounced with an error reduction up to 0.21°. Conclusion: The contribution of bone shape to model-derived joint kinematics appears to be relatively small and lack in clinical relevance.
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Affiliation(s)
- Joris De Roeck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Kate Duquesne
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Jan Van Houcke
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Emmanuel A Audenaert
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.,Department of Electromechanics, Op3Mech Research Group, University of Antwerp, Antwerp, Belgium
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5
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Karimi MT, Hemmati F, Mardani MA, Sharifmoradi K, Hosseini SI, Fadayevatan R, Esrafilian A. Determination of the correlation between muscle forces obtained from OpenSim and muscle activities obtained from electromyography in the elderly. Phys Eng Sci Med 2021; 44:243-251. [PMID: 33559039 DOI: 10.1007/s13246-021-00973-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/01/2022]
Abstract
Measurement of muscle forces related to aging can help to better identify the gait impairment mechanisms in the elderly. To this end, musculoskeletal modeling has been developed to estimate muscle forces. This study aimed to check the validity of OpenSim modeling (i.e., computed muscle control) approach in elderly subjects. Kinematic and kinetic data and Electromyography (EMG) signals for four different muscles were collected in nine healthy elderly males during walking. Dynamic simulation was done within OpenSim. Correlation analysis was performed to quantitatively compare the maximum estimated muscle forces with maximum measured muscle activities during the first double limb support, single limb support, and the second double limb support phases. The area-time plots of OpenSim and EMG data during gait cycle were obtained for qualitative assessment. In quantitative assessment, a low to moderate correlation was observed for the peak of muscle force and muscle activation of four muscles during sub phases of gait. The muscle forces pattern from OpenSim was found to be relatively similar to the muscle activity pattern from EMG especially for Gastrocnemius Medialis. A low to moderate consistency between OpenSim and EMG in the elderly can be explained by using a single mathematical estimation approach.
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Affiliation(s)
- Mohammad T Karimi
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Hemmati
- Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mohammad A Mardani
- Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Seyed Iman Hosseini
- Department of Mechanical and Aerospace Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Reza Fadayevatan
- Ageing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir Esrafilian
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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6
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Holder J, Trinler U, Meurer A, Stief F. A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment. Front Bioeng Biotechnol 2020; 8:603907. [PMID: 33365306 PMCID: PMC7750503 DOI: 10.3389/fbioe.2020.603907] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/10/2020] [Indexed: 11/13/2022] Open
Abstract
The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.
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Affiliation(s)
- Jana Holder
- Faculty of Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany.,Movement Analysis Laboratory, Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt am Main, Germany
| | - Ursula Trinler
- Laboratory for Movement Analysis, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Andrea Meurer
- Department of Special Orthopedics, Orthopedic University Hospital Friedrichsheim gGmbH, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Felix Stief
- Faculty of Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany.,Movement Analysis Laboratory, Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt am Main, Germany
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7
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Viitala R, Saikko V. Effect of random variation of input and various daily activities on wear in a hip joint simulator. J Biomech 2020; 106:109831. [PMID: 32517982 DOI: 10.1016/j.jbiomech.2020.109831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 11/24/2022]
Abstract
The ISO 14242-1 standard specifies fixed, simplified, sinusoidal motion and double-peak load cycles for wear testing of total hip prostheses. In order to make the wear simulation more realistic, random variation was added for the first time to the motion and load control signals of a hip joint simulator. For this purpose and for the simulation of various daily activities, computer-controlled, servo-electric drives were mounted on a biaxial hip simulator frame and successfully introduced. Random variation did not result in a statistically significant difference in the wear factor of large diameter VEXLPE liners compared with fixed sinusoidal waveforms. However, level walking according to biomechanical literature surprisingly resulted in a 134 per cent higher, and jogging in a 57 per cent lower wear factor compared with the fixed sinusoidal waveforms. These wear phenomena were likely to be caused by a variation in the lubrication conditions and frictional heating. Simplified motion waveforms may result in an underestimation of wear in walking.
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Affiliation(s)
| | - Vesa Saikko
- Aalto University School of Engineering, Finland.
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8
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An Anatomical-Based Subject-Specific Model of In-Vivo Knee Joint 3D Kinematics From Medical Imaging. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10062100] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Biomechanical models of the knee joint allow the development of accurate procedures as well as novel devices to restore the joint natural motion. They are also used within musculoskeletal models to perform clinical gait analysis on patients. Among relevant knee models in the literature, the anatomy-based spatial parallel mechanisms represent the joint motion using rigid links for the ligaments’ isometric fibres and point contacts for the articular surfaces. To customize analyses, therapies and devices, there is the need to define subject-specific models, but relevant procedures and their accuracy are still questioned. A procedure is here proposed and validated to define a customized knee model based on a spatial parallel mechanism. Computed tomography, magnetic resonance and 3D-video-fluoroscopy were performed on a healthy volunteer to define the personalized model geometry. The model was then validated by comparing the measured and the replicated joint motion. The model showed mean absolute difference and standard deviations in translations and rotations, respectively of 0.98 ± 0.40 mm and 0.68 ± 0.29 ° for the tibia–femur motion, and of 0.77 ± 0.15 mm and 2.09 ± 0.69 ° for the patella–femur motion. These results show that accurate personalized spatial models of knee kinematics can be obtained from in-vivo imaging.
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9
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Grabke EP, Masani K, Andrysek J. Lower Limb Assistive Device Design Optimization Using Musculoskeletal Modeling: A Review. J Med Device 2019. [DOI: 10.1115/1.4044739] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AbstractMany individuals with lower limb amputations or neuromuscular impairments face mobility challenges attributable to suboptimal assistive device design. Forward dynamic modeling and simulation of human walking using conventional biomechanical gait models offer an alternative to intuition-based assistive device design, providing insight into the biomechanics underlying pathological gait. Musculoskeletal models enable better understanding of prosthesis and/or exoskeleton contributions to the human musculoskeletal system, and device and user contributions to both body support and propulsion during gait. This paper reviews current literature that have used forward dynamic simulation of clinical population musculoskeletal models to perform assistive device design optimization using optimal control, optimal tracking, computed muscle control (CMC) and reflex-based control. Musculoskeletal model complexity and assumptions inhibit forward dynamic musculoskeletal modeling in its current state, hindering computational assistive device design optimization. Future recommendations include validating musculoskeletal models and resultant assistive device designs, developing less computationally expensive forward dynamic musculoskeletal modeling methods, and developing more efficient patient-specific musculoskeletal model generation methods to enable personalized assistive device optimization.
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Affiliation(s)
- Emerson Paul Grabke
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Kei Masani
- KITE—Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 3V9, Canada
| | - Jan Andrysek
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G1R8, Canada
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10
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Miehling J. Musculoskeletal modeling of user groups for virtual product and process development. Comput Methods Biomech Biomed Engin 2019; 22:1209-1218. [DOI: 10.1080/10255842.2019.1651296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jörg Miehling
- Engineering Design, Department of Mechanical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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11
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Begon M, Andersen MS, Dumas R. Multibody Kinematics Optimization for the Estimation of Upper and Lower Limb Human Joint Kinematics: A Systematized Methodological Review. J Biomech Eng 2019; 140:2666614. [PMID: 29238821 DOI: 10.1115/1.4038741] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Indexed: 11/08/2022]
Abstract
Multibody kinematics optimization (MKO) aims to reduce soft tissue artefact (STA) and is a key step in musculoskeletal modeling. The objective of this review was to identify the numerical methods, their validation and performance for the estimation of the human joint kinematics using MKO. Seventy-four papers were extracted from a systematized search in five databases and cross-referencing. Model-derived kinematics were obtained using either constrained optimization or Kalman filtering to minimize the difference between measured (i.e., by skin markers, electromagnetic or inertial sensors) and model-derived positions and/or orientations. While hinge, universal, and spherical joints prevail, advanced models (e.g., parallel and four-bar mechanisms, elastic joint) have been introduced, mainly for the knee and shoulder joints. Models and methods were evaluated using: (i) simulated data based, however, on oversimplified STA and joint models; (ii) reconstruction residual errors, ranging from 4 mm to 40 mm; (iii) sensitivity analyses which highlighted the effect (up to 36 deg and 12 mm) of model geometrical parameters, joint models, and computational methods; (iv) comparison with other approaches (i.e., single body kinematics optimization and nonoptimized kinematics); (v) repeatability studies that showed low intra- and inter-observer variability; and (vi) validation against ground-truth bone kinematics (with errors between 1 deg and 22 deg for tibiofemoral rotations and between 3 deg and 10 deg for glenohumeral rotations). Moreover, MKO was applied to various movements (e.g., walking, running, arm elevation). Additional validations, especially for the upper limb, should be undertaken and we recommend a more systematic approach for the evaluation of MKO. In addition, further model development, scaling, and personalization methods are required to better estimate the secondary degrees-of-freedom (DoF).
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Affiliation(s)
- Mickaël Begon
- Département de Kinésiologie, Université de Montréal, 1700 Jacques Tétreault, Laval, QC H7N 0B6, Canada.,Centre de Recherche du Centre Hospitalier, Universitaire Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada e-mail:
| | - Michael Skipper Andersen
- Department of Materials and Production, Aalborg University, Fibigerstrade 16, Aalborg East DK-9220, Denmark e-mail:
| | - Raphaël Dumas
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, Lyon F69622, France e-mail:
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12
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Jacquelin E, Brizard D, Dumas R. A screening method to analyse the sensitivity of a lower limb multibody kinematic model. Comput Methods Biomech Biomed Engin 2019; 22:925-935. [PMID: 30999767 DOI: 10.1080/10255842.2019.1604950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The study presents a screening method used to identify the influential parameters of a lower limb model including ligaments, at low numerical cost. Concerning multibody kinematics optimisation, the ligament parameters (isometric length) were found the most influential ones in a previous study. The screening method tested if they remain influential with minimised length variations. The most important parameters for tibiofemoral kinematics were the skin markers, segment lengths and joint parameters, including two ligaments. This was confirmed by a quantitative sensitivity analysis. The screening method has the potential to be used as a stand-alone procedure for a sensitivity analysis.
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Affiliation(s)
- Eric Jacquelin
- a Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406 , Lyon , France
| | - Denis Brizard
- a Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406 , Lyon , France
| | - Raphael Dumas
- a Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406 , Lyon , France
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13
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Zeighami A, Aissaoui R, Dumas R. Knee medial and lateral contact forces in a musculoskeletal model with subject-specific contact point trajectories. J Biomech 2018; 69:138-145. [PMID: 29397108 DOI: 10.1016/j.jbiomech.2018.01.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 01/08/2018] [Accepted: 01/14/2018] [Indexed: 01/27/2023]
Abstract
Contact point (CP) trajectory is a crucial parameter in estimating medial/lateral tibio-femoral contact forces from the musculoskeletal (MSK) models. The objective of the present study was to develop a method to incorporate the subject-specific CP trajectories into the MSK model. Ten healthy subjects performed 45 s treadmill gait trials. The subject-specific CP trajectories were constructed on the tibia and femur as a function of extension-flexion using low-dose bi-plane X-ray images during a quasi-static squat. At each extension-flexion position, the tibia and femur CPs were superimposed in the three directions on the medial side, and in the anterior-posterior and proximal-distal directions on the lateral side to form the five kinematic constraints of the knee joint. The Lagrange multipliers associated to these constraints directly yielded the medial/lateral contact forces. The results from the personalized CP trajectory model were compared against the linear CP trajectory and sphere-on-plane CP trajectory models which were adapted from the commonly used MSK models. Changing the CP trajectory had a remarkable impact on the knee kinematics and changed the medial and lateral contact forces by 1.03 BW and 0.65 BW respectively, in certain subjects. The direction and magnitude of the medial/lateral contact force were highly variable among the subjects and the medial-lateral shift of the CPs alone could not determine the increase/decrease pattern of the contact forces. The suggested kinematic constraints are adaptable to the CP trajectories derived from a variety of joint models and those experimentally measured from the 3D imaging techniques.
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Affiliation(s)
- A Zeighami
- Laboratoire de Recherche en Imagerie et Orthopédie (LIO), École de Technologie Supérieure (ÉTS), Center de Recherche du CHUM, Montréal, Québec, Canada.
| | - R Aissaoui
- Laboratoire de Recherche en Imagerie et Orthopédie (LIO), École de Technologie Supérieure (ÉTS), Center de Recherche du CHUM, Montréal, Québec, Canada.
| | - R Dumas
- Université Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMR_T9406, LBMC, F69622 Lyon, France.
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14
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Żuk M, Syczewska M, Pezowicz C. Use of the surface electromyography for a quantitative trend validation of estimated muscle forces. Biocybern Biomed Eng 2018. [DOI: 10.1016/j.bbe.2018.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Valente G, Crimi G, Vanella N, Schileo E, Taddei F. nmsBuilder: Freeware to create subject-specific musculoskeletal models for OpenSim. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 152:85-92. [PMID: 29054263 DOI: 10.1016/j.cmpb.2017.09.012] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/05/2017] [Accepted: 09/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Musculoskeletal modeling and simulations of movement have been increasingly used in orthopedic and neurological scenarios, with increased attention to subject-specific applications. In general, musculoskeletal modeling applications have been facilitated by the development of dedicated software tools; however, subject-specific studies have been limited also by time-consuming modeling workflows and high skilled expertise required. In addition, no reference tools exist to standardize the process of musculoskeletal model creation and make it more efficient. Here we present a freely available software application, nmsBuilder 2.0, to create musculoskeletal models in the file format of OpenSim, a widely-used open-source platform for musculoskeletal modeling and simulation. nmsBuilder 2.0 is the result of a major refactoring of a previous implementation that moved a first step toward an efficient workflow for subject-specific model creation. METHODS nmsBuilder includes a graphical user interface that provides access to all functionalities, based on a framework for computer-aided medicine written in C++. The operations implemented can be used in a workflow to create OpenSim musculoskeletal models from 3D surfaces. A first step includes data processing to create supporting objects necessary to create models, e.g. surfaces, anatomical landmarks, reference systems; and a second step includes the creation of OpenSim objects, e.g. bodies, joints, muscles, and the corresponding model. RESULTS We present a case study using nmsBuilder 2.0: the creation of an MRI-based musculoskeletal model of the lower limb. The model included four rigid bodies, five degrees of freedom and 43 musculotendon actuators, and was created from 3D surfaces of the segmented images of a healthy subject through the modeling workflow implemented in the software application. CONCLUSIONS We have presented nmsBuilder 2.0 for the creation of musculoskeletal OpenSim models from image-based data, and made it freely available via nmsbuilder.org. This application provides an efficient workflow for model creation and helps standardize the process. We hope this would help promote personalized applications in musculoskeletal biomechanics, including larger sample size studies, and might also represent a basis for future developments for specific applications.
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Affiliation(s)
- Giordano Valente
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, via di Barbiano 1/10, 40136 Bologna, Italy.
| | - Gianluigi Crimi
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Nicola Vanella
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Enrico Schileo
- Computational Bioengineering Laboratory, Rizzoli Orthopaedic Institute, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Fulvia Taddei
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, via di Barbiano 1/10, 40136 Bologna, Italy
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16
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Hannah I, Montefiori E, Modenese L, Prinold J, Viceconti M, Mazzà C. Sensitivity of a juvenile subject-specific musculoskeletal model of the ankle joint to the variability of operator-dependent input. Proc Inst Mech Eng H 2017; 231:415-422. [PMID: 28427313 PMCID: PMC5407509 DOI: 10.1177/0954411917701167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Subject-specific musculoskeletal modelling is especially useful in the study of juvenile and pathological subjects. However, such methodologies typically require a human operator to identify key landmarks from medical imaging data and are thus affected by unavoidable variability in the parameters defined and subsequent model predictions. The aim of this study was to thus quantify the inter- and intra-operator repeatability of a subject-specific modelling methodology developed for the analysis of subjects with juvenile idiopathic arthritis. Three operators each created subject-specific musculoskeletal foot and ankle models via palpation of bony landmarks, adjustment of geometrical muscle points and definition of joint coordinate systems. These models were then fused to a generic Arnold lower limb model for each of three modelled patients. The repeatability of each modelling operation was found to be comparable to those previously reported for the modelling of healthy, adult subjects. However, the inter-operator repeatability of muscle point definition was significantly greater than intra-operator repeatability (p < 0.05) and predicted ankle joint contact forces ranged by up to 24% and 10% of the peak force for the inter- and intra-operator analyses, respectively. Similarly, the maximum inter- and intra-operator variations in muscle force output were 64% and 23% of peak force, respectively. Our results suggest that subject-specific modelling is operator dependent at the foot and ankle, with the definition of muscle geometry the most significant source of output uncertainty. The development of automated procedures to prevent the misplacement of crucial muscle points should therefore be considered a particular priority for those developing subject-specific models.
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Affiliation(s)
- Iain Hannah
- 1 INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK.,2 Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | - Erica Montefiori
- 1 INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK.,2 Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | - Luca Modenese
- 1 INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK.,2 Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | - Joe Prinold
- 1 INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK.,2 Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | - Marco Viceconti
- 1 INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK.,2 Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | - Claudia Mazzà
- 1 INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK.,2 Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
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17
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Charbonnier C, Chagué S, Kolo FC, Duthon VB, Menetrey J. Multi-body optimization with subject-specific knee models: performance at high knee flexion angles. Comput Methods Biomech Biomed Engin 2017; 20:1571-1579. [DOI: 10.1080/10255842.2017.1390568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Sylvain Chagué
- Medical Research Department, Artanim Foundation, Meyrin, Switzerland
| | | | - Victoria B. Duthon
- Faculty of Medicine, Centre de Médecine de l’appareil locomoteur et du sport, Orthopedics and Trauma Service, University Hospitals of Geneva, Geneva, Switzerland
| | - Jacques Menetrey
- Centre de Médecine de l’appareil locomoteur et du sport, Orthopedics and Trauma Service, University Hospitals of Geneva, Geneva, Switzerland
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18
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Leardini A, Belvedere C, Nardini F, Sancisi N, Conconi M, Parenti-Castelli V. Kinematic models of lower limb joints for musculo-skeletal modelling and optimization in gait analysis. J Biomech 2017; 62:77-86. [DOI: 10.1016/j.jbiomech.2017.04.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/22/2017] [Accepted: 04/30/2017] [Indexed: 10/19/2022]
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19
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Kinematic models of the upper limb joints for multibody kinematics optimisation: An overview. J Biomech 2017; 62:87-94. [DOI: 10.1016/j.jbiomech.2016.12.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/08/2016] [Accepted: 12/05/2016] [Indexed: 11/19/2022]
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20
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Comparative assessment of knee joint models used in multi-body kinematics optimisation for soft tissue artefact compensation. J Biomech 2017; 62:95-101. [DOI: 10.1016/j.jbiomech.2017.01.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/20/2016] [Accepted: 01/16/2017] [Indexed: 11/18/2022]
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21
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Abstract
Advancing the knowledge of the biomechanics of the human body is essential to improve the clinical decision-makings of musculoskeletal disorders in the framework of in silico medicine. An impressive number of research projects focused on the development of rigid-body musculoskeletal models have been conducted over the world thanks to the new research directives. However, the application of these models in clinical practices remains a challenging issue. The objective of this review paper was to present the most current rigid-body musculoskeletal models of the human body systems and to analyze their trends and weaknesses for clinical applications. Then, recommendations were proposed for future researches toward fully clinical decision support. A systematic review process was performed. Well-selected studies related to the most current rigid-body 3D musculoskeletal models for each body system component (jaw, cervical spine, upper limbs, lumbar spine, and lower limbs) were summarized and explored. Trends in rigid musculoskeletal modeling are highlighted as personalization, new imaging techniques for specific joint kinematics, and computational efficiency. Weaknesses are highlighted as modeling assumptions, use of generic model, lack of modeling consensus, model validation, and parameter and model uncertainties. Future directions related to joint and muscle modeling, neuro-musculoskeletal modeling, model validation, data and model uncertainty quantification are recommended.
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Affiliation(s)
- Tien Tuan Dao
- Sorbonne University, Université de technologie de Compiègne, CNRS, UMR 7338 Biomechanics and Bioengineering, BP 20529, 60205 Compiègne cedex, France
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22
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Feasibility of using MRIs to create subject-specific parallel-mechanism joint models. J Biomech 2017; 53:45-55. [DOI: 10.1016/j.jbiomech.2016.12.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/10/2016] [Accepted: 12/19/2016] [Indexed: 11/21/2022]
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23
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Valente G, Pitto L, Schileo E, Piroddi S, Leardini A, Manfrini M, Taddei F. Relationship between bone adaptation and in-vivo mechanical stimulus in biological reconstructions after bone tumor: A biomechanical modeling analysis. Clin Biomech (Bristol, Avon) 2017; 42:99-107. [PMID: 28131017 DOI: 10.1016/j.clinbiomech.2017.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Biomechanical interpretations of bone adaptation in biological reconstructions following bone tumors would be crucial for orthopedic oncologists, particularly if based on quantitative observations. This would help plan for surgical treatments, rehabilitative programs and communication with the patients. We aimed to analyze the biomechanical adaptation of a femoral reconstruction after Ewing sarcoma according to an increasingly-used surgical technique, and to relate in-progress bone resorption to the mechanical stimulus induced by different motor activities. METHODS We created a multiscale musculoskeletal and finite element model from CT scans and motion analysis data at a 76-month follow-up of a patient, to analyze muscle and joint loads, and to compare the mechanical competence of the reconstructed bone with the contralateral limb, in the current real condition and in a possible revision surgery that removed proximal screws. FINDINGS Our results showed strategies of muscle coordination that led to differences in joint loads between limbs more marked in more demanding motor activities, and generally larger in the contralateral limb. The operated femur presented a markedly low ratio of physiological strain due to load-sharing with the metal implant, particularly in the lateral aspect. The possible revision surgery would help restore a physiological strain configuration, while the safety of the reconstruction would not be threatened. INTERPRETATION We suggest that bone resorption is related to load-sharing and to the internal forces exerted during movement, and the mechanical stimulus should be improved by adopting modifications in the surgical treatment and by promoting physical therapy aimed at specific muscle strengthening.
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Affiliation(s)
- Giordano Valente
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy.
| | - Lorenzo Pitto
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Enrico Schileo
- Computational Bioengineering Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Sabina Piroddi
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Alberto Leardini
- Movement Analysis Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Marco Manfrini
- Orthopedic and Traumatologic Clinic for Musculoskeletal Tumors, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Fulvia Taddei
- Medical Technology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy
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24
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Marouane H, Shirazi-Adl A, Adouni M. 3D active-passive response of human knee joint in gait is markedly altered when simulated as a planar 2D joint. Biomech Model Mechanobiol 2016; 16:693-703. [DOI: 10.1007/s10237-016-0846-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 10/14/2016] [Indexed: 12/26/2022]
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25
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Clément J, Dumas R, Hagemeister N, de Guise JA. Can generic knee joint models improve the measurement of osteoarthritic knee kinematics during squatting activity? Comput Methods Biomech Biomed Engin 2016; 20:94-103. [DOI: 10.1080/10255842.2016.1202935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Julien Clément
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
| | - Raphaël Dumas
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Laboratoire de Biomécanique et Mécanique des Chocs, IFSTTAR, UMR_T9406, Bron, France
| | - Nicola Hagemeister
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
| | - Jaques A. de Guise
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
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26
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Richard V, Lamberto G, Lu TW, Cappozzo A, Dumas R. Knee Kinematics Estimation Using Multi-Body Optimisation Embedding a Knee Joint Stiffness Matrix: A Feasibility Study. PLoS One 2016; 11:e0157010. [PMID: 27314586 PMCID: PMC4912111 DOI: 10.1371/journal.pone.0157010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 05/23/2016] [Indexed: 11/18/2022] Open
Abstract
The use of multi-body optimisation (MBO) to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. The present study proposes a knee joint model where femur and tibia are represented as rigid bodies connected through an elastic element the behaviour of which is described by a single stiffness matrix. The deformation energy, computed from the stiffness matrix and joint angles and displacements, is minimised within the MBO. Implemented as a "soft" constraint using a penalty-based method, this elastic joint description challenges the strictness of "hard" constraints. In this study, estimates of knee kinematics obtained using MBO embedding four different knee joint models (i.e., no constraints, spherical joint, parallel mechanism, and elastic joint) were compared against reference kinematics measured using bi-planar fluoroscopy on two healthy subjects ascending stairs. Bland-Altman analysis and sensitivity analysis investigating the influence of variations in the stiffness matrix terms on the estimated kinematics substantiate the conclusions. The difference between the reference knee joint angles and displacements and the corresponding estimates obtained using MBO embedding the stiffness matrix showed an average bias and standard deviation for kinematics of 0.9±3.2° and 1.6±2.3 mm. These values were lower than when no joint constraints (1.1±3.8°, 2.4±4.1 mm) or a parallel mechanism (7.7±3.6°, 1.6±1.7 mm) were used and were comparable to the values obtained with a spherical joint (1.0±3.2°, 1.3±1.9 mm). The study demonstrated the feasibility of substituting an elastic joint for more classic joint constraints in MBO.
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Affiliation(s)
- Vincent Richard
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMR_T9406, LBMC, F69622, Lyon, France
- Università degli Studi di Roma – Foro Italico, Department of Movement, Human, and Health Sciences, Rome, Italy
| | - Giuliano Lamberto
- University of Sheffield, Department of Mechanical Engineering and INSIGNEO Institute for in Silico Medicine, Sheffield, United Kingdom
| | - Tung-Wu Lu
- National Taiwan University, Institute of Biomedical Engineering, Taipei, Taiwan
- National Taiwan University, Department of Orthopaedic Surgery, Taipei, Taiwan
| | - Aurelio Cappozzo
- Università degli Studi di Roma – Foro Italico, Department of Movement, Human, and Health Sciences, Rome, Italy
| | - Raphaël Dumas
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMR_T9406, LBMC, F69622, Lyon, France
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27
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Subject-specific biomechanics of trunk: musculoskeletal scaling, internal loads and intradiscal pressure estimation. Biomech Model Mechanobiol 2016; 15:1699-1712. [DOI: 10.1007/s10237-016-0792-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
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