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Dranetz J, Chen S, Choi H. Impact of model geometry and joint center locations on inverse kinematic/dynamic predictions: A comparative study of sexually dimorphic models. J Biomech 2024; 169:112147. [PMID: 38768542 DOI: 10.1016/j.jbiomech.2024.112147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/14/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
This work illustrates the sensitivity of demographically characteristic body segment inertial properties and subject-specific customization on model performance. One characteristic demographic, gender, and one subject-specific characteristic, hip joint center location, were represented with musculoskeletal modeling to evaluate how design decisions may alter model outputs. Generic sexually dimorphic musculoskeletal models were developed from the commonly used Rajagopal model using male and female data adapted by Dumas et al. Hip joint centers of these models were adjusted based on functional joint center testing. The kinematics and dynamics of 40 gait cycles from four subjects are predicted using these models. Two-way analysis of variance (ANOVA) was performed on the continuous time series data using statistical parametric mapping (SPM) to assess changes in kinematics/dynamics due to either choice in model (Rajagopal vs Dumas) or whether joint center adjustment was performed. The SPM based two-way ANOVA of the inverse dynamics found that differences in the Rajagopal and Dumas models resulted in significant differences in sagittal plane moments during swing (0.115 ± 0.032 Nm/kg difference in mean hip flexion moment during initial swing and a 0.077 ± 0.041 Nm/kg difference in mean hip extension moment during terminal swing), and differences between the models with and without hip joint center adjustment resulted in significant differences in hip flexion and abduction moments during stance (0.217 ± 0.055 Nm/kg increased mean hip abductive moment). By comparing the outputs of these differently constructed models with each other, the study finds that dynamic predictions of stance are sensitive to positioning of joint centers, and dynamic predictions of swing are more sensitive to segment mass/inertial properties.
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Affiliation(s)
- Joseph Dranetz
- Department of Mechanical and Aerospace Engineering, Biionix Cluster, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, United States.
| | - Shuo Chen
- Department of Mechanical and Aerospace Engineering, Biionix Cluster, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, United States.
| | - Hwan Choi
- Department of Mechanical and Aerospace Engineering, Biionix Cluster, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, United States.
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Fougeron N, Bonnet X, Panhelleux B, Rose JL, Rohan PY, Pillet H. Effect of the ischial support on muscle force estimation during transfemoral walking. Prosthet Orthot Int 2024:00006479-990000000-00242. [PMID: 38619545 DOI: 10.1097/pxr.0000000000000348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 02/01/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Transmission of loads between the prosthetic socket and the residual limb is critical for the comfort and walking ability of people with transfemoral amputation. This transmission is mainly determined by the socket tightening, muscle forces, and socket ischial support. However, numerical investigations of the amputated gait, using modeling approaches such as MusculoSkeletal (MSK) modeling, ignore the weight-bearing role of the ischial support. This simplification may lead to errors in the muscle force estimation. OBJECTIVE This study aims to propose a MSK model of the amputated gait that accounts for the interaction between the body and the ischial support for the estimation of the muscle forces of 13 subjects with unilateral transfemoral amputation. METHODS Contrary to previous studies on the amputated gait which ignored the interaction with the ischial support, here, the contact on the ischial support was included in the external loads acting on the pelvis in a MSK model of the amputated gait. RESULTS Including the ischial support induced an increase in the activity of the main abductor muscles, while adductor muscles' activity was reduced. These results suggest that neglecting the interaction with the ischial support leads to erroneous muscle force distribution considering the gait of people with transfemoral amputation. Although subjects with various bone geometries, particularly femur lengths, were included in the study, similar results were obtained for all subjects. CONCLUSIONS Eventually, the estimation of muscle forces from MSK models could be used in combination with finite element models to provide quantitative data for the design of prosthetic sockets.
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Affiliation(s)
- Nolwenn Fougeron
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
- Proteor, Recherche et développement, Dijon, France
| | - Xavier Bonnet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Brieuc Panhelleux
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Pierre-Yves Rohan
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Hélène Pillet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
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Klemt C, Yeo I, Harvey M, Burns JC, Melnic C, Uzosike AC, Kwon YM. The Use of Artificial Intelligence for the Prediction of Periprosthetic Joint Infection Following Aseptic Revision Total Knee Arthroplasty. J Knee Surg 2024; 37:158-166. [PMID: 36731501 DOI: 10.1055/s-0043-1761259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Periprosthetic joint infection (PJI) following revision total knee arthroplasty (TKA) for aseptic failure is associated with poor outcomes, patient morbidity, and high health care expenditures. The aim of this study was to develop novel machine learning algorithms for the prediction of PJI following revision TKA for patients with aseptic indications for revision surgery. A single-institution database consisting of 1,432 consecutive revision TKA patients with aseptic etiologies was retrospectively identified. The patient cohort included 208 patients (14.5%) who underwent re-revision surgery for PJI. Three machine learning algorithms (artificial neural networks, support vector machines, k-nearest neighbors) were developed to predict this outcome and these models were assessed by discrimination, calibration, and decision curve analysis. This is a retrospective study. Among the three machine learning models, the neural network model achieved the best performance across discrimination (area under the receiver operating characteristic curve = 0.78), calibration, and decision curve analysis. The strongest predictors for PJI following revision TKA for aseptic reasons were prior open procedure prior to revision surgery, drug abuse, obesity, and diabetes. This study utilized machine learning as a tool for the prediction of PJI following revision TKA for aseptic failure with excellent performance. The validated machine learning models can aid surgeons in patient-specific risk stratifying to assist in preoperative counseling and clinical decision making for patients undergoing aseptic revision TKA.
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Affiliation(s)
- Christian Klemt
- Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ingwon Yeo
- Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael Harvey
- Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jillian C Burns
- Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christopher Melnic
- Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Akachimere Cosmas Uzosike
- Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Young-Min Kwon
- Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Toderita D, Favier CD, Henson DP, Vardakastani V, Sherman K, Bennett AN, Bull AMJ. Hip joint and muscle loading for persons with bilateral transfemoral/through-knee amputations: biomechanical differences between full-length articulated and foreshortened non-articulated prostheses. J Neuroeng Rehabil 2023; 20:169. [PMID: 38115144 PMCID: PMC10729544 DOI: 10.1186/s12984-023-01296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Currently, there is little available in-depth analysis of the biomechanical effect of different prostheses on the musculoskeletal system function and residual limb internal loading for persons with bilateral transfemoral/through-knee amputations (BTF). Commercially available prostheses for BTF include full-length articulated prostheses (microprocessor-controlled prosthetic knees with dynamic response prosthetic feet) and foreshortened non-articulated stubby prostheses. This study aims to assess and compare the BTF musculoskeletal function and loading during gait with these two types of prostheses. METHODS Gait data were collected from four male traumatic military BTF and four able-bodied (AB) matched controls using a 10-camera motion capture system with two force plates. BTF completed level-ground walking trials with full-length articulated and foreshortened non-articulated stubby prostheses. Inverse kinematics, inverse dynamics and musculoskeletal modelling simulations were conducted. RESULTS Full-length articulated prostheses introduced larger stride length (by 0.5 m) and walking speed (by 0.3 m/s) than stubbies. BTF with articulated prostheses showed larger peak hip extension angles (by 10.1°), flexion moment (by 1.0 Nm/kg) and second peak hip contact force (by 3.8 bodyweight) than stubbies. There was no difference in the hip joint loading profile between BTF with stubbies and AB for one gait cycle. Full-length articulated prostheses introduced higher hip flexor muscle force impulse than stubbies. CONCLUSIONS Compared to stubbies, BTF with full-length articulated prostheses can achieve similar activity levels to persons without limb loss, but this may introduce detrimental muscle and hip joint loading, which may lead to reduced muscular endurance and joint degeneration. This study provides beneficial guidance in making informed decisions for prosthesis choice.
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Affiliation(s)
- Diana Toderita
- Department of Bioengineering, Imperial College London, London, UK.
| | - Clement D Favier
- Department of Bioengineering, Imperial College London, London, UK
| | - David P Henson
- Department of Bioengineering, Imperial College London, London, UK
| | | | | | | | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK
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Perry JL, Gilbert IR, Xing F, Jin R, Kuehn DP, Shosted RK, Woo J, Liang ZP, Sutton BP. Preliminary Development of an MRI Atlas for Application to Cleft Care: Findings and Future Recommendations. Cleft Palate Craniofac J 2023:10556656231183385. [PMID: 37335134 DOI: 10.1177/10556656231183385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE To introduce a highly innovative imaging method to study the complex velopharyngeal (VP) system and introduce the potential future clinical applications of a VP atlas in cleft care. DESIGN Four healthy adults participated in a 20-min dynamic magnetic resonance imaging scan that included a high-resolution T2-weighted turbo-spin-echo 3D structural scan and five custom dynamic speech imaging scans. Subjects repeated a variety of phrases when in the scanner as real-time audio was captured. SETTING Multisite institution and clinical setting. PARTICIPANTS Four adult subjects with normal anatomy were recruited for this study. MAIN OUTCOME Establishment of 4-D atlas constructed from dynamic VP MRI data. RESULTS Three-dimensional dynamic magnetic resonance imaging was successfully used to obtain high quality dynamic speech scans in an adult population. Scans were able to be re-sliced in various imaging planes. Subject-specific MR data were then reconstructed and time-aligned to create a velopharyngeal atlas representing the averaged physiological movements across the four subjects. CONCLUSIONS The current preliminary study examined the feasibility of developing a VP atlas for potential clinical applications in cleft care. Our results indicate excellent potential for the development and use of a VP atlas for assessing VP physiology during speech.
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Affiliation(s)
- Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Imani R Gilbert
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Fangxu Xing
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Riwei Jin
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - David P Kuehn
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Ryan K Shosted
- Department of Linguistics, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Jonghye Woo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Zhi-Pei Liang
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Bradley P Sutton
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Benton AM, Amiri P, Henson DP, Sivapuratharasu B, Mcgregor AH, Bull AMJ. Characterization of muscle recruitment during gait of bilateral transfemoral and through-knee persons with limb loss. Front Bioeng Biotechnol 2023; 11:1128528. [PMID: 37082215 PMCID: PMC10110921 DOI: 10.3389/fbioe.2023.1128528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/17/2023] [Indexed: 04/22/2023] Open
Abstract
Introduction: Due to loss in musculoskeletal capacity, there is an increased burden on the residual limbs of bilateral transfemoral and through-knee persons with limb loss. This reduced capacity is associated with an increased cost of walking that is detrimental to functionality. Compensatory gait strategies are adopted by this population. However, how these strategies relate to specific muscle recruitment is not known. The primary aim of this study is to characterize muscle recruitment during gait of this population. The secondary aim is to assess whether the measured kinematics can be actuated when the endurance of specific muscles is reduced and if this is the case, which alternative muscles facilitate this. Methods: 3D gait data and high-resolution magnetic resonance images were acquired from six bilateral transfemoral and through-knee persons with limb loss. Subject-specific anatomical muscle models were developed for each participant, and a validated musculoskeletal model was used to quantify muscle forces in two conditions: during normal gait (baseline) and when muscles, which were identified as functioning above a "healthy" level at baseline, have a reduced magnitude of maximum force capacity (reduced endurance simulation). To test the hypothesis that there are differences in muscle forces between the baseline trials and the simulations with reduced muscular endurance, a Bonferroni corrected two-way ANOVA with repeated measures was completed between the two states. Results: The baseline analysis showed that the hip flexors experience relatively high muscle activations during gait. The reduced endurance simulation found two scenarios. First, for 5 out of the 12 simulations, the baseline kinematics could not be reproduced with the reduced muscular capacity. Second, for 7 out of 12 cases where the baseline kinematics were achieved, this was possible with compensatory increased activation of some muscles with similar functions (p ≤ 0.003). Discussion: Evidently, due to the loss of the ankle plantar flexors, gait imposes a high demand on the flexor muscle group of the residual limb. This study highlights how the elevated cost of gait in this population manifests in muscle recruitment. To enhance functionality, it is critical to consider the mechanical demand on the hip flexors and to develop rehabilitation interventions accordingly.
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Affiliation(s)
- Alice M. Benton
- Department of Bioengineering, Imperial College London, London, United Kingdom
- *Correspondence: Alice M. Benton,
| | - Pouya Amiri
- Department of Bioengineering, Imperial College London, London, United Kingdom
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
| | - David P. Henson
- Department of Bioengineering, Imperial College London, London, United Kingdom
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
| | - Biranavan Sivapuratharasu
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Alison H. Mcgregor
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Anthony M. J. Bull
- Department of Bioengineering, Imperial College London, London, United Kingdom
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
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Amiri P, Bull AMJ. Prediction of in vivo hip contact forces during common activities of daily living using a segment-based musculoskeletal model. Front Bioeng Biotechnol 2022; 10:995279. [PMID: 36588939 PMCID: PMC9797521 DOI: 10.3389/fbioe.2022.995279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Quantifying in vivo hip muscle and contact forces during activities of daily living (ADL) provides valuable information for diagnosis and treatment of hip-related disorders. The objective of this study was to utilize Freebody, a segment-based musculoskeletal model, for the prediction of hip contact forces using a novel objective function during seven common ADLs and validate its performance against the publicly available HIP98 dataset. Methods: Marker data, ground reaction forces, and hip contact forces during slow, normal, and fast walking, stair ascent and descent, and standing up and sitting down were extracted for 3 subjects from the HIP98 dataset. A musculoskeletal anatomical dataset was scaled to match the dimensions of each subject, and muscle and hip contact forces were estimated by minimizing a novel objective function, which was the summation of the muscle stresses squared and body weight-normalised hip contact force. The accuracy of predictions were quantified using several metrics, and muscle forces were qualitatively compared to experimental EMGs in the literature. Results: FreeBody predicted the hip contact forces during the ADLs with encouraging accuracy: The root mean squared error of predictions were 44.0 ± 8.5, 47.4 ± 6.5, and 59.8 ± 7.1% BW during slow, normal, and fast walking, 44.2 ± 16.8% and 53.3 ± 12.2% BW for stair ascent and descent, and 31.8 ± 8.2% and 17.1 ± 5.0% BW for standing up and sitting down, respectively. The error in prediction of peak hip contact forces were 14-18%, 24-28%, 17-35% for slow, normal, and fast walking, 7-25% and 15-32% in stair ascent and descent, and around 10% for standing up and sitting down. The coefficient of determination was larger than 0.90 in all activities except in standing up (0.86 ± 0.08). Conclusion: This study has implemented a novel objective function in a segment-based musculoskeletal model, FreeBody, for the prediction of hip contact forces during a large range of ADLs. The model outputs compare favourably for all ADLs and are the best in standing up and sitting down, while muscle activation patterns are consistent with experimental EMGs from literature. This new objective function addresses one of the major limitations associated with musculoskeletal models in the literature, namely the high non-physiological predicted hip joint contact forces.
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