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Caillet AH, Phillips ATM, Modenese L, Farina D. NeuroMechanics: Electrophysiological and computational methods to accurately estimate the neural drive to muscles in humans in vivo. J Electromyogr Kinesiol 2024; 76:102873. [PMID: 38518426 DOI: 10.1016/j.jelekin.2024.102873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024] Open
Abstract
The ultimate neural signal for muscle control is the neural drive sent from the spinal cord to muscles. This neural signal comprises the ensemble of action potentials discharged by the active spinal motoneurons, which is transmitted to the innervated muscle fibres to generate forces. Accurately estimating the neural drive to muscles in humans in vivo is challenging since it requires the identification of the activity of a sample of motor units (MUs) that is representative of the active MU population. Current electrophysiological recordings usually fail in this task by identifying small MU samples with over-representation of higher-threshold with respect to lower-threshold MUs. Here, we describe recent advances in electrophysiological methods that allow the identification of more representative samples of greater numbers of MUs than previously possible. This is obtained with large and very dense arrays of electromyographic electrodes. Moreover, recently developed computational methods of data augmentation further extend experimental MU samples to infer the activity of the full MU pool. In conclusion, the combination of new electrode technologies and computational modelling allows for an accurate estimate of the neural drive to muscles and opens new perspectives in the study of the neural control of movement and in neural interfacing.
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Affiliation(s)
| | - Andrew T M Phillips
- Department of Civil and Environmental Engineering, Imperial College London, UK
| | - Luca Modenese
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
| | - Dario Farina
- Department of Bioengineering, Imperial College London, UK.
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Caillet AH, Phillips ATM, Farina D, Modenese L. Motoneuron-driven computational muscle modelling with motor unit resolution and subject-specific musculoskeletal anatomy. PLoS Comput Biol 2023; 19:e1011606. [PMID: 38060619 PMCID: PMC10729998 DOI: 10.1371/journal.pcbi.1011606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/19/2023] [Accepted: 10/16/2023] [Indexed: 12/20/2023] Open
Abstract
The computational simulation of human voluntary muscle contraction is possible with EMG-driven Hill-type models of whole muscles. Despite impactful applications in numerous fields, the neuromechanical information and the physiological accuracy such models provide remain limited because of multiscale simplifications that limit comprehensive description of muscle internal dynamics during contraction. We addressed this limitation by developing a novel motoneuron-driven neuromuscular model, that describes the force-generating dynamics of a population of individual motor units, each of which was described with a Hill-type actuator and controlled by a dedicated experimentally derived motoneuronal control. In forward simulation of human voluntary muscle contraction, the model transforms a vector of motoneuron spike trains decoded from high-density EMG signals into a vector of motor unit forces that sum into the predicted whole muscle force. The motoneuronal control provides comprehensive and separate descriptions of the dynamics of motor unit recruitment and discharge and decodes the subject's intention. The neuromuscular model is subject-specific, muscle-specific, includes an advanced and physiological description of motor unit activation dynamics, and is validated against an experimental muscle force. Accurate force predictions were obtained when the vector of experimental neural controls was representative of the discharge activity of the complete motor unit pool. This was achieved with large and dense grids of EMG electrodes during medium-force contractions or with computational methods that physiologically estimate the discharge activity of the motor units that were not identified experimentally. This neuromuscular model advances the state-of-the-art of neuromuscular modelling, bringing together the fields of motor control and musculoskeletal modelling, and finding applications in neuromuscular control and human-machine interfacing research.
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Affiliation(s)
- Arnault H. Caillet
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Andrew T. M. Phillips
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
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Lloyd DG, Jonkers I, Delp SL, Modenese L. The History and Future of Neuromusculoskeletal Biomechanics. J Appl Biomech 2023; 39:273-283. [PMID: 37751904 DOI: 10.1123/jab.2023-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 09/28/2023]
Abstract
The Executive Council of the International Society of Biomechanics has initiated and overseen the commemorations of the Society's 50th Anniversary in 2023. This included multiple series of lectures at the ninth World Congress of Biomechanics in 2022 and XXIXth Congress of the International Society of Biomechanics in 2023, all linked to special issues of International Society of Biomechanics' affiliated journals. This special issue of the Journal of Applied Biomechanics is dedicated to the biomechanics of the neuromusculoskeletal system. The reader is encouraged to explore this special issue which comprises 6 papers exploring the current state-of the-art, and future directions and roles for neuromusculoskeletal biomechanics. This editorial presents a very brief history of the science of the neuromusculoskeletal system's 4 main components: the central nervous system, musculotendon units, the musculoskeletal system, and joints, and how they biomechanically integrate to enable an understanding of the generation and control of human movement. This also entails a quick exploration of contemporary neuromusculoskeletal biomechanics and its future with new fields of application.
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Affiliation(s)
- David G Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, School of Health Science and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Ilse Jonkers
- Institute of Physics-Based Modeling for in Silico Health, Human Movement Science Department, KU Leuven, Leuven, Belgium
| | - Scott L Delp
- Bioengineering, Mechanical Engineering and Orthopedic Surgery, and Wu Tsai Human Performance Alliance at Stanford, Stanford University, Stanford, CA, USA
| | - Luca Modenese
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, Australia
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Caillet AH, Avrillon S, Kundu A, Yu T, Phillips ATM, Modenese L, Farina D. Larger and Denser: An Optimal Design for Surface Grids of EMG Electrodes to Identify Greater and More Representative Samples of Motor Units. eNeuro 2023; 10:ENEURO.0064-23.2023. [PMID: 37657923 PMCID: PMC10500983 DOI: 10.1523/eneuro.0064-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 09/03/2023] Open
Abstract
The spinal motor neurons are the only neural cells whose individual activity can be noninvasively identified. This is usually done using grids of surface electromyographic (EMG) electrodes and source separation algorithms; an approach called EMG decomposition. In this study, we combined computational and experimental analyses to assess how the design parameters of grids of electrodes influence the number and the properties of the identified motor units. We first computed the percentage of motor units that could be theoretically discriminated within a pool of 200 simulated motor units when decomposing EMG signals recorded with grids of various sizes and interelectrode distances (IEDs). Increasing the density, the number of electrodes, and the size of the grids, increased the number of motor units that our decomposition algorithm could theoretically discriminate, i.e., up to 83.5% of the simulated pool (range across conditions: 30.5-83.5%). We then identified motor units from experimental EMG signals recorded in six participants with grids of various sizes (range: 2-36 cm2) and IED (range: 4-16 mm). The configuration with the largest number of electrodes and the shortest IED maximized the number of identified motor units (56 ± 14; range: 39-79) and the percentage of early recruited motor units within these samples (29 ± 14%). Finally, the number of identified motor units further increased with a prototyped grid of 256 electrodes and an IED of 2 mm. Taken together, our results showed that larger and denser surface grids of electrodes allow to identify a more representative pool of motor units than currently reported in experimental studies.
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Affiliation(s)
- Arnault H Caillet
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, United Kingdom
| | - Simon Avrillon
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
| | - Aritra Kundu
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
| | - Tianyi Yu
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
| | - Andrew T M Phillips
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, United Kingdom
| | - Luca Modenese
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, New South Wales 1466, Australia
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
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Caillet AH, Phillips ATM, Farina D, Modenese L. Estimation of the firing behaviour of a complete motoneuron pool by combining electromyography signal decomposition and realistic motoneuron modelling. PLoS Comput Biol 2022; 18:e1010556. [PMID: 36174126 PMCID: PMC9553065 DOI: 10.1371/journal.pcbi.1010556] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 10/11/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022] Open
Abstract
Our understanding of the firing behaviour of motoneuron (MN) pools during human voluntary muscle contractions is currently limited to electrophysiological findings from animal experiments extrapolated to humans, mathematical models of MN pools not validated for human data, and experimental results obtained from decomposition of electromyographical (EMG) signals. These approaches are limited in accuracy or provide information on only small partitions of the MN population. Here, we propose a method based on the combination of high-density EMG (HDEMG) data and realistic modelling for predicting the behaviour of entire pools of motoneurons in humans. The method builds on a physiologically realistic model of a MN pool which predicts, from the experimental spike trains of a smaller number of individual MNs identified from decomposed HDEMG signals, the unknown recruitment and firing activity of the remaining unidentified MNs in the complete MN pool. The MN pool model is described as a cohort of single-compartment leaky fire-and-integrate (LIF) models of MNs scaled by a physiologically realistic distribution of MN electrophysiological properties and driven by a spinal synaptic input, both derived from decomposed HDEMG data. The MN spike trains and effective neural drive to muscle, predicted with this method, have been successfully validated experimentally. A representative application of the method in MN-driven neuromuscular modelling is also presented. The proposed approach provides a validated tool for neuroscientists, experimentalists, and modelers to infer the firing activity of MNs that cannot be observed experimentally, investigate the neuromechanics of human MN pools, support future experimental investigations, and advance neuromuscular modelling for investigating the neural strategies controlling human voluntary contractions. Our experimental understanding of the firing behaviour of motoneuron (MN) pools during human voluntary muscle contractions is currently limited to the observation of small samples of active MNs obtained from EMG decomposition. EMG decomposition therefore provides an important but incomplete description of the role of individual MNs in the firing activity of the complete MN pool, which limits our understanding of the neural strategies of the whole MN pool and of how the firing activity of each MN contributes to the neural drive to muscle. Here, we combine decomposed high-density EMG (HDEMG) data and a physiologically realistic model of MN population to predict the unknown recruitment and firing activity of the remaining unidentified MNs in the complete MN pool. In brief, an experimental estimation of the synaptic current is input to a cohort of MN models, which are calibrated using the available decomposed HDEMG data, and predict the MN spike trains fired by the entire MN population. This novel approach is experimentally validated and applied to muscle force prediction from neuromuscular modelling.
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Affiliation(s)
- Arnault H. Caillet
- Department of Civil and Environmental Engineering, Imperial College London, United Kingdom
| | - Andrew T. M. Phillips
- Department of Civil and Environmental Engineering, Imperial College London, United Kingdom
| | - Dario Farina
- Department of Bioengineering, Imperial College London, United Kingdom
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, United Kingdom
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
- * E-mail:
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Caillet AHD, Phillips ATM, Farina D, Modenese L. Mathematical relationships between spinal motoneuron properties. eLife 2022; 11:76489. [PMID: 35848819 PMCID: PMC9612914 DOI: 10.7554/elife.76489] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Our understanding of the behaviour of spinal alpha-motoneurons (MNs) in mammals partly relies on our knowledge of the relationships between MN membrane properties, such as MN size, resistance, rheobase, capacitance, time constant, axonal conduction velocity, and afterhyperpolarization duration. We reprocessed the data from 40 experimental studies in adult cat, rat, and mouse MN preparations to empirically derive a set of quantitative mathematical relationships between these MN electrophysiological and anatomical properties. This validated mathematical framework, which supports past findings that the MN membrane properties are all related to each other and clarifies the nature of their associations, is besides consistent with the Henneman’s size principle and Rall’s cable theory. The derived mathematical relationships provide a convenient tool for neuroscientists and experimenters to complete experimental datasets, explore the relationships between pairs of MN properties never concurrently observed in previous experiments, or investigate inter-mammalian-species variations in MN membrane properties. Using this mathematical framework, modellers can build profiles of inter-consistent MN-specific properties to scale pools of MN models, with consequences on the accuracy and the interpretability of the simulations. Muscles receive their instructions through electrical signals carried by tens or hundreds of cells connected to the command centers of the body. These ‘alpha-motoneurons’ have various sizes and electrical characteristics which affect how they transmit signals. Previous experiments have shown that these properties are linked; for instance, larger motoneurons transfer electrical signals more quickly. The exact nature of the mathematical relationships between these characteristics, however, remains unclear. This limits our understanding of the behaviour of motoneurons from experimental data. To identify the equations linking eight motoneuron properties, Caillet et al. analysed published datasets from experimental studies on cat motoneurons. This approach uncovered simple mathematical associations: in fact, only one characteristic needs to be measured experimentally to calculate all the other properties. The relationships identified were also consistent with previously accepted approaches for modelling motoneuron activity. Caillet et al. then validated this mathematical framework with data from studies on rodents, showing that some of the equations hold true for different mammals. This work offers a quick and easy way for researchers to calculate the characteristics of a motoneuron based on a single observation. This will allow non-measured properties to be added to experimental datasets, and it could help to uncover the diversity of motoneurons at work within a population.
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Affiliation(s)
- Arnault H D Caillet
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Andrew T M Phillips
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
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Bicer M, Phillips AT, Modenese L. Altering the strength of the muscles crossing the lower limb joints only affects knee joint reaction forces. Gait Posture 2022; 95:210-216. [PMID: 35550278 DOI: 10.1016/j.gaitpost.2022.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/17/2022] [Accepted: 03/25/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Generic musculoskeletal models based on literature data are often used to estimate joint reaction forces (JRFs) that otherwise could only be measured invasively. Estimated JRFs are sensitive to changes in maximum isometric force (Fiso) of the muscles, but these are normally simply scaled using a multiplicative coefficient. The impact of varying Fiso, or strength, of muscles crossing each lower limb joint on estimated JRFs has not been systematically explored in musculoskeletal models of the lower limb. RESEARCH QUESTION How do alterations in the strength of joint-crossing muscles influence the lower limb JRF magnitudes computed through a generic musculoskeletal model? METHODS By modifying Fiso of muscles crossing hip, knee, ankle, or all joints at once up to ± 40% in 10% increments, thirty-two models were created to simulate the gait of a patient with an instrumented tibial prosthesis (5th Grand Challenge dataset). A standard workflow (inverse kinematics, static optimization, joint reaction analysis) was utilized to calculate JRFs. Both alterations in JRF magnitudes due to joint crossing muscles' strength modifications and their accuracy against in vivo knee loading measurements were quantified. RESULTS The knee JRF was the most sensitive force to changes in the joint-crossing muscles' strength (variations ranging from -37.9 ± 0.5% to +37.9 ± 3.2%), while the hip and ankle JRFs were almost unaffected (maximum variation: +6.1%). Reducing the strength of knee and ankle-crossing muscles and intensifying the strength of hip-crossing muscles lowered the knee JRF. The knee JRF was best estimated (peak error: 0.42 ± 0.15 body weight, root mean squared error: 0.37 ± 0.06 body weight, coefficient of determination: 0.76 ± 0.10) by the model with -40% weakened knee-crossing muscles. SIGNIFICANCE Altering strengths mainly affects knee JRF estimated with generic musculoskeletal models, suggesting that personalization of strength of joint-crossing muscles is required for accurate knee JRF estimations. Rehabilitation regimes meant to strengthen muscles crossing a joint should be carefully designed to avoid undesired effects on the other joints.
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Affiliation(s)
- Metin Bicer
- Department of Civil and Environmental Engineering, Imperial College London, London, UK.
| | - Andrew Tm Phillips
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, London, UK; Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
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Diamond LE, Barrett RS, Modenese L, Anderson AE, Hall M. Editorial: Neuromechanics of Hip Osteoarthritis. Front Sports Act Living 2021; 3:788263. [PMID: 34859205 PMCID: PMC8631320 DOI: 10.3389/fspor.2021.788263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Rod S Barrett
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Andrew E Anderson
- University of Utah Motion Capture Core Facility, University of Utah, Salt Lake City, UT, United States
| | - Michelle Hall
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, VIC, Australia
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Curreli C, Di Puccio F, Davico G, Modenese L, Viceconti M. Using Musculoskeletal Models to Estimate in vivo Total Knee Replacement Kinematics and Loads: Effect of Differences Between Models. Front Bioeng Biotechnol 2021; 9:703508. [PMID: 34395407 PMCID: PMC8357266 DOI: 10.3389/fbioe.2021.703508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/23/2021] [Indexed: 01/29/2023] Open
Abstract
Total knee replacement (TKR) is one of the most performed orthopedic surgeries to treat knee joint diseases in the elderly population. Although the survivorship of knee implants may extend beyond two decades, the poor outcome rate remains considerable. A recent computational approach used to better understand failure modes and improve TKR outcomes is based on the combination of musculoskeletal (MSK) and finite element models. This combined multiscale modeling approach is a promising strategy in the field of computational biomechanics; however, some critical aspects need to be investigated. In particular, the identification and quantification of the uncertainties related to the boundary conditions used as inputs to the finite element model due to a different definition of the MSK model are crucial. Therefore, the aim of this study is to investigate this problem, which is relevant for the model credibility assessment process. Three different generic MSK models available in the OpenSim platform were used to simulate gait, based on the experimental data from the fifth edition of the "Grand Challenge Competitions to Predict in vivo Knee Loads." The outputs of the MSK analyses were compared in terms of relative kinematics of the knee implant components and joint reaction (JR) forces and moments acting on the tibial insert. Additionally, the estimated knee JRs were compared with those measured by the instrumented knee implant so that the "global goodness of fit" was quantified for each model. Our results indicated that the different kinematic definitions of the knee joint and the muscle model implemented in the different MSK models influenced both the motion and the load history of the artificial joint. This study demonstrates the importance of examining the influence of the model assumptions on the output results and represents the first step for future studies that will investigate how the uncertainties in the MSK models propagate on disease-specific finite element model results.
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Affiliation(s)
- Cristina Curreli
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Francesca Di Puccio
- Dipartimento di Ingegneria Civile e Industriale, Università di Pisa, Pisa, Italy
| | - Giorgio Davico
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Maine S, Ngo-Nguyen C, Barzan M, Stockton C, Modenese L, Lloyd D, Carty C. Bisect offset ratio and cartilaginous sulcus angle are good combined predictors of recurrent patellar dislocation in children and adolescents. J ISAKOS 2021; 6:265-270. [PMID: 33893181 DOI: 10.1136/jisakos-2020-000461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Recurrent patellar dislocation (RPD) is found most commonly in the juvenile population. While risk factors have been well-established in adults, there remains a paucity in radiographical data to define normal and pathoanatomical juvenile cohorts. The objectives of this paper were to elucidate the differences in the patellofemoral joint between RPD and typically developed (TD) juvenile populations, using MRI measurements, and determine the best independent and combined predictors of RPD. METHODS A prospective, cross-sectional study was conducted with 25 RPD and 24 TD participants aged between 8 and 19 years. MR images were obtained to assess common measures of lower limb alignment, patellofemoral alignment, and trochlear dysplasia. RESULTS Significant differences were evident for acetabular inclination, tibial-femoral torsion, tibial tubercle-to-trochlear groove (TT-TG) distance, lateral patellar tilt (LPT), cartilaginous sulcus angle (CSA) and bisect offset ratio (BOR). CSA and BOR were included in the final predictive model, which correctly classified 89.4% of RPD cases. CONCLUSION Radiographical parameters that stratify risk of RPD in adults are also able to predict RPD in the pediatric population (TT-TG, LPT, CSA and BOR). Together, CSA and BOR accurately identified 89.4% of RPD. These measures should be included in the evaluation of pediatric patients who present with patellar dislocation. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Sheanna Maine
- Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast, Queensland, Australia
| | - Christina Ngo-Nguyen
- Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Martina Barzan
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast, Queensland, Australia
| | - Chris Stockton
- Medical Imaging and Nuclear Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Luca Modenese
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast, Queensland, Australia.,Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - David Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast, Queensland, Australia
| | - Christopher Carty
- Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Griffith University, Gold Coast, Queensland, Australia
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Benemerito I, Modenese L, Montefiori E, Mazzà C, Viceconti M, Lacroix D, Guo L. An extended discrete element method for the estimation of contact pressure at the ankle joint during stance phase. Proc Inst Mech Eng H 2020; 234:507-516. [PMID: 32036769 PMCID: PMC7469707 DOI: 10.1177/0954411920905434] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abnormalities in the ankle contact pressure are related to the onset of osteoarthritis. In vivo measurements are not possible with currently available techniques, so computational methods such as the finite element analysis (FEA) are often used instead. The discrete element method (DEM), a computationally efficient alternative to time-consuming FEA, has also been used to predict the joint contact pressure. It describes the articular cartilage as a bed of independent springs, assuming a linearly elastic behaviour and absence of relative motion between the bones. In this study, we present the extended DEM (EDEM) which is able to track the motion of talus over time. The method was used, with input data from a subject-specific musculoskeletal model, to predict the contact pressure in the ankle joint during gait. Results from EDEM were also compared with outputs from conventional DEM. Predicted values of contact area were larger in EDEM than they were in DEM (4.67 and 4.18 cm2, respectively). Peak values of contact pressure, attained at the toe-off, were 7.3 MPa for EDEM and 6.92 MPa for DEM. Values predicted from EDEM fell well within the ranges reported in the literature. Overall, the motion of the talus had more effect on the extension and shape of the pressure distribution than it had on the magnitude of the pressure. The results indicated that EDEM is a valid methodology for the prediction of ankle contact pressure during daily activities.
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Affiliation(s)
- Ivan Benemerito
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield, UK
| | - Luca Modenese
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Erica Montefiori
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
| | - Claudia Mazzà
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Damien Lacroix
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK
| | - Lingzhong Guo
- INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.,Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield, UK
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Montefiori E, Modenese L, Di Marco R, Magni-Manzoni S, Malattia C, Petrarca M, Ronchetti A, de Horatio LT, van Dijkhuizen P, Wang A, Wesarg S, Viceconti M, Mazzà C. Linking Joint Impairment and Gait Biomechanics in Patients with Juvenile Idiopathic Arthritis. Ann Biomed Eng 2019; 47:2155-2167. [PMID: 31111329 PMCID: PMC6838035 DOI: 10.1007/s10439-019-02287-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/08/2019] [Indexed: 11/27/2022]
Abstract
Juvenile Idiopathic Arthritis (JIA) is a paediatric musculoskeletal disease of unknown aetiology, leading to walking alterations when the lower-limb joints are involved. Diagnosis of JIA is mostly clinical. Imaging can quantify impairments associated to inflammation and joint damage. However, treatment planning could be better supported using dynamic information, such as joint contact forces (JCFs). To this purpose, we used a musculoskeletal model to predict JCFs and investigate how JCFs varied as a result of joint impairment in eighteen children with JIA. Gait analysis data and magnetic resonance images (MRI) were used to develop patient-specific lower-limb musculoskeletal models, which were evaluated for operator-dependent variability (< 3.6°, 0.05 N kg-1 and 0.5 BW for joint angles, moments, and JCFs, respectively). Gait alterations and JCF patterns showed high between-subjects variability reflecting the pathology heterogeneity in the cohort. Higher joint impairment, assessed with MRI-based evaluation, was weakly associated to overall joint overloading. A stronger correlation was observed between impairment of one limb and overload of the contralateral limb, suggesting risky compensatory strategies being adopted, especially at the knee level. This suggests that knee overloading during gait might be a good predictor of disease progression and gait biomechanics should be used to inform treatment planning.
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Affiliation(s)
- Erica Montefiori
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK.
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK.
| | - Luca Modenese
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Roberto Di Marco
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, Italy
| | - Silvia Magni-Manzoni
- Pediatric Rheumatology Unit, IRCCS "Bambino Gesù" Children's Hospital, Passoscuro, Rome, Italy
| | - Clara Malattia
- Pediatria II - Reumatologia, Istituto Giannina Gaslini, Genoa, Italy
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARLab), Neurorehabilitation Units, IRCCS "Bambino Gesù" Children's Hospital, Passoscuro, Rome, Italy
| | - Anna Ronchetti
- UOC Medicina Fisica e Riabilitazione, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Pieter van Dijkhuizen
- Paediatric Immunology, University Medical Centre Utrecht Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Anqi Wang
- Visual Healthcare Technologies, Fraunhofer IGD, Darmstadt, Germany
| | - Stefan Wesarg
- Visual Healthcare Technologies, Fraunhofer IGD, Darmstadt, Germany
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudia Mazzà
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
- INSIGNEO Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
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13
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van Veen B, Montefiori E, Modenese L, Mazzà C, Viceconti M. Muscle recruitment strategies can reduce joint loading during level walking. J Biomech 2019; 97:109368. [PMID: 31606129 DOI: 10.1016/j.jbiomech.2019.109368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 10/25/2022]
Abstract
Joint inflammation, with consequent cartilage damage and pain, typically reduces functionality and affects activities of daily life in a variety of musculoskeletal diseases. Since mechanical loading is an important determinant of the disease process, a possible conservative treatment is the unloading of joints. In principle, a neuromuscular rehabilitation program aimed to promote alternative muscle recruitments could reduce the loads on the lower-limb joints during walking. The extent of joint load reduction one could expect from this approach remains unknown. Furthermore, assuming significant reductions of the load on the affected joint can be achieved, it is unclear whether, and to what extent, the other joints will be overloaded. Using subject-specific musculoskeletal models of four different participants, we computed the muscle recruitment strategies that minimised the hip, knee and ankle contact force, and predicted the contact forces such strategies induced at the other joints. Significant reductions of the peak force and impulse at the knee and hip were obtained, while only a minimal effect was found at the ankle joint. Adversely, the peak force and the impulse in non-targeted joints increased when aiming to minimize the load in an adjacent joint. These results confirm the potential of alternative muscle recruitment strategies to reduce the loading at the knee and the hip, but not at the ankle. Therefore, neuromuscular rehabilitation can be targeted to reduce the loading at affected joints but must be considered carefully in patients with multiple joints affected due to the potential adverse effects in non-targeted joints.
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Affiliation(s)
- Bart van Veen
- Department of Mechanical Engineering and INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK
| | - Erica Montefiori
- Department of Mechanical Engineering and INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK
| | - Luca Modenese
- Department of Mechanical Engineering and INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK; Department of Civil and Environmental Engineering, Imperial College London, UK
| | - Claudia Mazzà
- Department of Mechanical Engineering and INSIGNEO Institute for in Silico Medicine, University of Sheffield, UK.
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Italy; Medical Technology Lab, Rizzoli Orthopaedic Institute, Bologna, Italy
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14
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Barzan M, Modenese L, Carty CP, Maine S, Stockton CA, Sancisi N, Lewis A, Grant J, Lloyd DG, Brito da Luz S. Development and validation of subject-specific pediatric multibody knee kinematic models with ligamentous constraints. J Biomech 2019; 93:194-203. [DOI: 10.1016/j.jbiomech.2019.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 05/16/2019] [Accepted: 07/02/2019] [Indexed: 01/08/2023]
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15
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Saxby DJ, Bryant AL, Van Ginckel A, Wang Y, Wang X, Modenese L, Gerus P, Konrath JM, Fortin K, Wrigley TV, Bennell KL, Cicuttini FM, Vertullo C, Feller JA, Whitehead T, Gallie P, Lloyd DG. Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2-3 years following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2019; 27:707-715. [PMID: 29881886 DOI: 10.1007/s00167-018-5006-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 06/01/2018] [Indexed: 01/12/2023]
Abstract
PURPOSE External loading of osteoarthritic and healthy knees correlates with current and future osteochondral tissue state. These relationships have not been examined following anterior cruciate ligament reconstruction. We hypothesised greater magnitude tibiofemoral contact forces were related to increased prevalence of osteochondral pathologies, and these relationships were exacerbated by concomitant meniscal injury. METHODS This was a cross-sectional study of 100 individuals (29.7 ± 6.5 years, 78.1 ± 14.4 kg) examined 2-3 years following hamstring tendon anterior cruciate ligament reconstruction. Thirty-eight participants had concurrent meniscal pathology (30.6 ± 6.6 years, 83.3 ± 14.3 kg), which included treated and untreated meniscal injury, and 62 participants (29.8 ± 6.4 years, 74.9 ± 13.3 kg) were free of meniscal pathology. Magnetic resonance imaging of reconstructed knees was used to assess prevalence of tibiofemoral osteochondral pathologies (i.e., cartilage defects and bone marrow lesions). A calibrated electromyogram-driven neuromusculoskeletal model was used to predict medial and lateral tibiofemoral compartment contact forces from gait analysis data. Relationships between contact forces and osteochondral pathology prevalence were assessed using logistic regression models. RESULTS In patients with reconstructed knees free from meniscal pathology, greater medial contact forces were related to reduced prevalence of medial cartilage defects (odds ratio (OR) = 0.7, Wald χ2(2) = 7.9, 95% confidence interval (CI) = 0.50-95, p = 0.02) and medial bone marrow lesions (OR = 0.8, Wald χ2(2) = 4.2, 95% CI = 0.7-0.99, p = 0.04). No significant relationships were found in lateral compartments. In reconstructed knees with concurrent meniscal pathology, no relationships were found between contact forces and osteochondral pathologies. CONCLUSIONS In patients with reconstructed knees free from meniscal pathology, increased contact forces were associated with fewer cartilage defects and bone marrow lesions in medial, but not, lateral tibiofemoral compartments. No significant relationships were found between contact forces and osteochondral pathologies in reconstructed knees with meniscal pathology for any tibiofemoral compartment. Future studies should focus on determining longitudinal effects of contact forces and changes in osteochondral pathologies. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- David John Saxby
- Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. .,School of Allied Health Sciences, Griffith University, Gold Coast, Australia. .,Gold Coast Orthopaedic Research and Education Alliance, Griffith University, Gold Coast, Australia. .,Room 2.05, G02, Clinical Sciences 1, Griffith University, Gold Coast Campus, Gold Coast, 4222, Australia.
| | - Adam L Bryant
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
| | - Ans Van Ginckel
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xinyang Wang
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Pauline Gerus
- Laboratory of Human Motion, Education and Health, University of Nice Sophia-Antipolis, Nice, France
| | - Jason M Konrath
- Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Gold Coast Orthopaedic Research and Education Alliance, Griffith University, Gold Coast, Australia
| | - Karine Fortin
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
| | - Tim V Wrigley
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Christopher Vertullo
- Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Gold Coast Orthopaedic Research and Education Alliance, Griffith University, Gold Coast, Australia.,Knee Research Australia, Gold Coast, Australia
| | - Julian A Feller
- OrthoSport Victoria, Epworth Richmond, Melbourne, Australia.,College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Tim Whitehead
- College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | | | - David G Lloyd
- Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Gold Coast Orthopaedic Research and Education Alliance, Griffith University, Gold Coast, Australia
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16
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Montefiori E, Modenese L, Di Marco R, Magni-Manzoni S, Malattia C, Petrarca M, Ronchetti A, de Horatio LT, van Dijkhuizen P, Wang A, Wesarg S, Viceconti M, Mazzà C. An image-based kinematic model of the tibiotalar and subtalar joints and its application to gait analysis in children with Juvenile Idiopathic Arthritis. J Biomech 2019; 85:27-36. [DOI: 10.1016/j.jbiomech.2018.12.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 10/06/2018] [Accepted: 12/28/2018] [Indexed: 01/08/2023]
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17
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Tagliapietra L, Modenese L, Ceseracciu E, Mazzà C, Reggiani M. Validation of a model-based inverse kinematics approach based on wearable inertial sensors. Comput Methods Biomech Biomed Engin 2018; 21:834-844. [PMID: 30466324 DOI: 10.1080/10255842.2018.1522532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Wearable inertial measurement units (IMUs) are a promising solution to human motion estimation. Using IMUs 3D orientations, a model-driven inverse kinematics methodology to estimate joint angles is presented. Estimated joint angles were validated against encoder-measured kinematics (robot) and against marker-based kinematics (passive mechanism). Results are promising, with RMS angular errors respectively lower than 3 and 6 deg over a minimum range of motion of 50 deg (robot) and 160 deg (passive mechanism). Moreover, a noise robustness analysis revealed that the model-driven approach reduces the effects of experimental noises, making the proposed technique particularly suitable for application in human motion analysis.
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Affiliation(s)
- L Tagliapietra
- a Department of Management and Engineering , University of Padua , Vicenza , Italy
| | - L Modenese
- b Department of Mechanical Engineering , University of Sheffield , Sheffield , UK.,c INSIGNEO Institute for in-silico medicine, University of Sheffield , Sheffield , UK
| | - E Ceseracciu
- a Department of Management and Engineering , University of Padua , Vicenza , Italy
| | - C Mazzà
- b Department of Mechanical Engineering , University of Sheffield , Sheffield , UK.,c INSIGNEO Institute for in-silico medicine, University of Sheffield , Sheffield , UK
| | - M Reggiani
- a Department of Management and Engineering , University of Padua , Vicenza , Italy
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18
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Ng KCG, Mantovani G, Modenese L, Beaulé PE, Lamontagne M. Altered Walking and Muscle Patterns Reduce Hip Contact Forces in Individuals With Symptomatic Cam Femoroacetabular Impingement. Am J Sports Med 2018; 46:2615-2623. [PMID: 30074815 DOI: 10.1177/0363546518787518] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cam-type femoroacetabular impingement (FAI) is a causative factor for hip pain and early hip osteoarthritis. Although cam FAI can alter hip joint biomechanics, it is unclear what role muscle forces play and how they affect the hip joint loading. Purpose/Hypothesis: The purpose was to examine the muscle contributions and hip contact forces in individuals with symptomatic cam FAI during level walking. Patients with symptomatic cam FAI would demonstrate different muscle and hip contact forces during gait. STUDY DESIGN Controlled laboratory study. METHODS Eighteen patients with symptomatic cam FAI were matched for age and body mass index with 18 control participants. Each participant's walking kinematics and kinetics were recorded throughout a gait cycle (ipsilateral foot-strike to ipsilateral foot-off) by use of a motion capture system and force plates. Muscle and hip contact forces were subsequently computed by use of a musculoskeletal modeling program and static optimization methods. RESULTS The FAI group walked slower and with shorter steps, demonstrating reduced joint motions and moments during contralateral foot-strike, compared with the control group. The FAI group showed reduced psoas major (median, 1.1 newtons per bodyweight [N/BW]; interquartile range [IQR], 1.0-1.5 N/BW) and iliacus forces (median, 1.2 N/BW; IQR, 1.0-1.6 N/BW), during contralateral foot-strike, compared with the control group (median, 1.6 N/BW; IQR, 1.3-1.6 N/BW, P = .004; and median, 1.5 N/BW; IQR, 1.3-1.6 N/BW, P = .03, respectively), which resulted in lower hip contact forces in the anterior ( P = .026), superior ( P = .02), and medial directions ( P = .038). The 3 vectors produced a resultant peak force at the anterosuperior aspect of the acetabulum for both groups, with the FAI group demonstrating a substantially lower magnitude. CONCLUSION FAI participants altered their walking kinematics and kinetics, especially during contralateral foot-strike, as a protective mechanism, which resulted in reduced psoas major and iliacus muscle force and anterosuperior hip contact force estimations. CLINICAL RELEVANCE Limited hip mobility not only is attributed to bone-on-bone impingement, caused by cam morphology, but could be attributed to musculature as well. Not only would the psoas major and iliacus be able to protect the hip joint during flexion-extension, athletic conditioning could further strengthen core muscles for improved hip mobility and pelvic balance.
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Affiliation(s)
- K C Geoffrey Ng
- Department of Mechanical Engineering, Imperial College London, London, UK
- Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Ontario, Canada
| | - Giulia Mantovani
- Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Ontario, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Luca Modenese
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Paul E Beaulé
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Mario Lamontagne
- Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Ontario, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
- Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario, Canada
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19
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Barzan M, Maine S, Modenese L, Lloyd DG, Carty CP. Patellofemoral joint alignment is a major risk factor for recurrent patellar dislocation in children and adolescents: a systematic review. J ISAKOS 2018. [DOI: 10.1136/jisakos-2017-000189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
ImportanceThe complex interplay of risk factors that predispose individuals to recurrent patellar dislocation is poorly understood, especially in paediatric patients who exhibit the most severe forms.ObjectiveThe primary aim of this study was to systematically review the current literature to characterise the lower limb alignment, patellofemoral morphology and soft tissue restraints of the patellofemoral joint (PFJ) through medical imaging measurements in paediatric recurrent patellar dislocators and age-matched control participants. The secondary aims were to synthesise the data to stratify the factors that influence PFJ stability and provide recommendations on the assessment and reporting of PFJ parameters in this patient population.Evidence reviewA systematic search was performed using CINAHL, the Cochrane Library, EMBASE, PubMed and Web of Science databases until June 2017. Two authors independently searched for studies that included typical children and adolescents who experienced patellar dislocation and also had direct measures of structural and dynamic risk factors. The methodological quality of the included studies was assessed through a customised version of the Downs and Black checklist. Weighted averages and SDs of measures that have been reported in more than one study were computed. A fixed-effects model was used to estimate the mean differences with 95% CIs regarding the association of recurrent patellar dislocation with patella alta, tibial tuberosity to trochlear groove (TT-TG) distance and bony sulcus angle.Findings20 of 718 articles met the inclusion criteria. Thirty-one risk factors were found; however, only 10 of these measurements had been assessed in multiple articles and only four had both dislocator and control population results. With respect to controls, patients with recurrent patellar dislocations had higher TT-TG distance (p<0.01) and higher bony sulcus angle (p<0.01).Conclusions and relevanceBased on the current scientific literature, increased TT-TG distances and bony sulcus angles predispose children and adolescents to recurrent patellar dislocation. Besides these measurements, studies reporting on recurrent patellar dislocation in children and adolescents should also include characterisation of lower limb alignment in coronal and axial planes and assessment of generalised ligamentous laxity.Level of evidenceSystematic review of prognostic studies, Levels II–IV.
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20
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Modenese L, Montefiori E, Wang A, Wesarg S, Viceconti M, Mazzà C. Investigation of the dependence of joint contact forces on musculotendon parameters using a codified workflow for image-based modelling. J Biomech 2018; 73:108-118. [DOI: 10.1016/j.jbiomech.2018.03.039] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 02/09/2018] [Accepted: 03/21/2018] [Indexed: 11/24/2022]
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21
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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22
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Kainz H, Carty CP, Maine S, Walsh HPJ, Lloyd DG, Modenese L. Effects of hip joint centre mislocation on gait kinematics of children with cerebral palsy calculated using patient-specific direct and inverse kinematic models. Gait Posture 2017. [PMID: 28641160 DOI: 10.1016/j.gaitpost.2017.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Joint kinematics can be calculated by Direct Kinematics (DK), which is used in most clinical gait laboratories, or Inverse Kinematics (IK), which is mainly used for musculoskeletal research. In both approaches, joint centre locations are required to compute joint angles. The hip joint centre (HJC) in DK models can be estimated using predictive or functional methods, while in IK models can be obtained by scaling generic models. The aim of the current study was to systematically investigate the impact of HJC location errors on lower limb joint kinematics of a clinical population using DK and IK approaches. Subject-specific kinematic models of eight children with cerebral palsy were built from magnetic resonance images and used as reference models. HJC was then perturbed in 6mm steps within a 60mm cubic grid, and kinematic waveforms were calculated for the reference and perturbed models. HJC perturbations affected only hip and knee joint kinematics in a DK framework, but all joint angles were affected when using IK. In the DK model, joint constraints increased the sensitivity of joint range-of-motion to HJC location errors. Mean joint angle offsets larger than 5° were observed for both approaches (DK and IK), which were larger than previously reported for healthy adults. In the absence of medical images to identify the HJC, predictive or functional methods with small errors in anterior-posterior and medial-lateral directions and scaling procedures minimizing HJC location errors in the anterior-posterior direction should be chosen to minimize the impact on joint kinematics.
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Affiliation(s)
- Hans Kainz
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia; Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Christopher P Carty
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia
| | - Sheanna Maine
- Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia
| | - Henry P J Walsh
- Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia
| | - David G Lloyd
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Luca Modenese
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Department of Mechanical Engineering, The University of Sheffield, United Kingdom; INSIGNEO Institute for In Silico Medicine, The University of Sheffield, United Kingdom.
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23
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Saxby DJ, Bryant AL, Wang X, Modenese L, Gerus P, Konrath JM, Bennell KL, Fortin K, Wrigley T, Cicuttini FM, Vertullo CJ, Feller JA, Whitehead T, Gallie P, Lloyd DG. Relationships Between Tibiofemoral Contact Forces and Cartilage Morphology at 2 to 3 Years After Single-Bundle Hamstring Anterior Cruciate Ligament Reconstruction and in Healthy Knees. Orthop J Sports Med 2017; 5:2325967117722506. [PMID: 28894756 PMCID: PMC5582666 DOI: 10.1177/2325967117722506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Prevention of knee osteoarthritis (OA) following anterior cruciate ligament (ACL) rupture and reconstruction is vital. Risk of postreconstruction knee OA is markedly increased by concurrent meniscal injury. It is unclear whether reconstruction results in normal relationships between tibiofemoral contact forces and cartilage morphology and whether meniscal injury modulates these relationships. HYPOTHESES Since patients with isolated reconstructions (ie, without meniscal injury) are at lower risk for knee OA, we predicted that relationships between tibiofemoral contact forces and cartilage morphology would be similar to those of normal, healthy knees 2 to 3 years postreconstruction. In knees with meniscal injuries, these relationships would be similar to those reported in patients with knee OA, reflecting early degenerative changes. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Three groups were examined: (1) 62 patients who received single-bundle hamstring reconstruction with an intact, uninjured meniscus (mean age, 29.8 ± 6.4 years; mean weight, 74.9 ± 13.3 kg); (2) 38 patients with similar reconstruction with additional meniscal injury (ie, tear, repair) or partial resection (mean age, 30.6 ± 6.6 years; mean weight, 83.3 ± 14.3 kg); and (3) 30 ligament-normal, healthy individuals (mean age, 28.3 ± 5.2 years; mean weight, 74.9 ± 14.9 kg) serving as controls. All patients underwent magnetic resonance imaging to measure the medial and lateral tibial articular cartilage morphology (volumes and thicknesses). An electromyography-driven neuromusculoskeletal model determined medial and lateral tibiofemoral contact forces during walking. General linear models were used to assess relationships between tibiofemoral contact forces and cartilage morphology. RESULTS In control knees, cartilage was thicker compared with that of isolated and meniscal-injured ACL-reconstructed knees, while greater contact forces were related to both greater tibial cartilage volumes (medial: R2 = 0.43, β = 0.62, P = .000; lateral: R2 = 0.19, β = 0.46, P = .03) and medial thicknesses (R2 = 0.24, β = 0.48, P = .01). In the overall group of ACL-reconstructed knees, greater contact forces were related to greater lateral cartilage volumes (R2 = 0.08, β = 0.28, P = .01). In ACL-reconstructed knees with lateral meniscal injury, greater lateral contact forces were related to greater lateral cartilage volumes (R2 = 0.41, β = 0.64, P = .001) and thicknesses (R2 = 0.20, β = 0.46, P = .04). CONCLUSION At 2 to 3 years postsurgery, ACL-reconstructed knees had thinner cartilage compared with healthy knees, and there were no positive relationships between medial contact forces and cartilage morphology. In lateral meniscal-injured reconstructed knees, greater contact forces were related to greater lateral cartilage volumes and thicknesses, although it was unclear whether this was an adaptive response or associated with degeneration. Future clinical studies may seek to establish whether cartilage morphology can be modified through rehabilitation programs targeting contact forces directly in addition to the current rehabilitation foci of restoring passive and dynamic knee range of motion, knee strength, and functional performance.
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Affiliation(s)
| | - David John Saxby
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Adam L Bryant
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xinyang Wang
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Luca Modenese
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Pauline Gerus
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jason M Konrath
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kim L Bennell
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Karine Fortin
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tim Wrigley
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Flavia M Cicuttini
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Christopher J Vertullo
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Julian A Feller
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tim Whitehead
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Price Gallie
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - David G Lloyd
- Investigation performed at School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia; and the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Erdemir A, Guess TM, Halloran JP, Modenese L, Reinbolt JA, Thelen DG, Umberger BR, Erdemir A, Guess TM, Halloran JP, Modenese L, Reinbolt JA, Thelen DG, Umberger BR, Umberger BR, Erdemir A, Thelen DG, Guess TM, Reinbolt JA, Modenese L, Halloran JP. Commentary on the integration of model sharing and reproducibility analysis to scholarly publishing workflow in computational biomechanics. IEEE Trans Biomed Eng 2017; 63:2080-2085. [PMID: 28072567 DOI: 10.1109/tbme.2016.2602760] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The overall goal of this paper is to demonstrate that dissemination of models and analyses for assessing the reproducibility of simulation results can be incorporated in the scientific review process in biomechanics. METHODS As part of a special issue on model sharing and reproducibility in the IEEE Transactions on Biomedical Engineering, two manuscripts on computational biomechanics were submitted: Rajagopal et al., IEEE Trans. Biomed. Eng., 2016 and Schmitz and Piovesan, IEEE Trans. Biomed. Eng., 2016. Models used in these studies were shared with the scientific reviewers and the public. In addition to the standard review of the manuscripts, the reviewers downloaded the models and performed simulations that reproduced results reported in the studies. RESULTS There was general agreement between simulation results of the authors and those of the reviewers. Discrepancies were resolved during the necessary revisions. The manuscripts and instructions for download and simulation were updated in response to the reviewers' feedback; changes that may otherwise have been missed if explicit model sharing and simulation reproducibility analysis was not conducted in the review process. Increased burden on the authors and the reviewers, to facilitate model sharing and to repeat simulations, were noted. CONCLUSION When the authors of computational biomechanics studies provide access to models and data, the scientific reviewers can download and thoroughly explore the model, perform simulations, and evaluate simulation reproducibility beyond the traditional manuscript-only review process. SIGNIFICANCE Model sharing and reproducibility analysis in scholarly publishing will result in a more rigorous review process, which will enhance the quality of modeling and simulation studies and inform future users of computational models.
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Barber L, Carty C, Modenese L, Walsh J, Boyd R, Lichtwark G. Medial gastrocnemius and soleus muscle-tendon unit, fascicle, and tendon interaction during walking in children with cerebral palsy. Dev Med Child Neurol 2017; 59:843-851. [PMID: 28369824 DOI: 10.1111/dmcn.13427] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2017] [Indexed: 11/28/2022]
Abstract
AIM This study investigates the in vivo function of the medial gastrocnemius and soleus muscle-tendon units (MTU), fascicles, and tendons during walking in children with cerebral palsy (CP) and an equinus gait pattern. METHOD Fourteen children with CP (9 males, 5 females; mean age 10y 6mo, standard deviation [SD] 2y 11mo; GMFCS level I=8, II=6), and 10 typically developing (6 males, 4 females; mean age 10y, SD 2y 1mo) undertook full body 3D gait analysis and simultaneous B-mode ultrasound images of the medial gastrocnemius and soleus fascicles during level walking. Fascicle lengths were analysed using a semi-automated tracking algorithm and MTUs using OpenSim. Statistical parametric mapping (two-sample t-test) was used to compare differences between groups (p<0.05). RESULTS In the CP group medial gastrocnemius fascicles lengthened during mid-stance gait and remained longer into late-stance compared to the typically developing group (p<0.001). CP medial gastrocnemius fascicles shortened less during stance (1.16mm [SD 1.47mm]) compared to the typically developing group (4.48mm [SD 1.94mm], p<0.001). In the CP group the medial gastrocnemius and soleus MTU and tendon were longer during early- and mid-stance (p<0.001). Ankle power during push-off (p=0.015) and positive work (p<0.002) and net work (p<0.001) were significantly lower in the CP group. INTERPRETATION Eccentric action of the CP medial gastrocnemius muscle fascicles during mid-stance walking is consistent with reduced volume and neuromuscular control of impaired muscle. Reduced ankle push-off power and positive work in the children with CP may be attributed to reduced active medial gastrocnemius fascicle shortening. These findings suggest a reliance on passive force generation for forward propulsion during equinus gait.
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Affiliation(s)
- Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Chris Carty
- Queensland Children's Motion Analysis Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.,Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Gold Coast, Australia
| | - Luca Modenese
- Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Gold Coast, Australia.,Department of Mechanical Engineering and INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - John Walsh
- Queensland Children's Motion Analysis Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Roslyn Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Glen Lichtwark
- School of Human Movement Studies, The University of Queensland, St Lucia, Australia
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Kainz H, Graham D, Edwards J, Walsh HPJ, Maine S, Boyd RN, Lloyd DG, Modenese L, Carty CP. Reliability of four models for clinical gait analysis. Gait Posture 2017; 54:325-331. [PMID: 28411552 DOI: 10.1016/j.gaitpost.2017.04.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/31/2017] [Accepted: 04/01/2017] [Indexed: 02/02/2023]
Abstract
Three-dimensional gait analysis (3DGA) has become a common clinical tool for treatment planning in children with cerebral palsy (CP). Many clinical gait laboratories use the conventional gait analysis model (e.g. Plug-in-Gait model), which uses Direct Kinematics (DK) for joint kinematic calculations, whereas, musculoskeletal models, mainly used for research, use Inverse Kinematics (IK). Musculoskeletal IK models have the advantage of enabling additional analyses which might improve the clinical decision-making in children with CP. Before any new model can be used in a clinical setting, its reliability has to be evaluated and compared to a commonly used clinical gait model (e.g. Plug-in-Gait model) which was the purpose of this study. Two testers performed 3DGA in eleven CP and seven typically developing participants on two occasions. Intra- and inter-tester standard deviations (SD) and standard error of measurement (SEM) were used to compare the reliability of two DK models (Plug-in-Gait and a six degrees-of-freedom model solved using Vicon software) and two IK models (two modifications of 'gait2392' solved using OpenSim). All models showed good reliability (mean SEM of 3.0° over all analysed models and joint angles). Variations in joint kinetics were less in typically developed than in CP participants. The modified 'gait2392' model which included all the joint rotations commonly reported in clinical 3DGA, showed reasonable reliable joint kinematic and kinetic estimates, and allows additional musculoskeletal analysis on surgically adjustable parameters, e.g. muscle-tendon lengths, and, therefore, is a suitable model for clinical gait analysis.
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Affiliation(s)
- Hans Kainz
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia; Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium.
| | - David Graham
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Julie Edwards
- Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
| | - Henry P J Walsh
- Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
| | - Sheanna Maine
- Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Australia.
| | - David G Lloyd
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Luca Modenese
- Department of Mechanical Engineering, University of Sheffield, United Kingdom; INSIGNEO Institute for In Silico Medicine, The University of Sheffield, United Kingdom, United Kingdom.
| | - Christopher P Carty
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
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27
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von Sturm K, Belogurov S, Brugnera R, Garfagnini A, Lippi I, Modenese L, Rosso D, Turcato M. A Compton scattering setup for pulse shape discrimination studies in germanium detectors. Appl Radiat Isot 2017; 125:163-168. [PMID: 28453976 DOI: 10.1016/j.apradiso.2017.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/11/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
Pulse shape discrimination is an important handle to improve sensitivity in low background experiments. A dedicated setup was built to investigate the response of high-purity germanium detectors to single Compton scattered events. Using properly collimated γ-ray sources, it is possible to select events with known interaction location. The aim is to correlate the position dependent signal shape with geometrical and electrical properties of the detector. We report on design and performance of the setup with a first look on data.
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Affiliation(s)
- K von Sturm
- Dipartimento di Fisica e Astronomia, Università di Padova, IT-35131 Padova, Italy; INFN Sezione di Padova, IT-35131 Padova, Italy.
| | - S Belogurov
- Flerov Laboratory for Nuclear Reactions, Joint Institute for Nuclear Research, 141980 Dubna, Russia
| | - R Brugnera
- Dipartimento di Fisica e Astronomia, Università di Padova, IT-35131 Padova, Italy; INFN Sezione di Padova, IT-35131 Padova, Italy
| | - A Garfagnini
- Dipartimento di Fisica e Astronomia, Università di Padova, IT-35131 Padova, Italy; INFN Sezione di Padova, IT-35131 Padova, Italy
| | - I Lippi
- INFN Sezione di Padova, IT-35131 Padova, Italy
| | - L Modenese
- INFN Sezione di Padova, IT-35131 Padova, Italy
| | - D Rosso
- INFN Laboratori Nazionali di Legnaro, IT-35020 Padova, Italy
| | - M Turcato
- INFN Sezione di Padova, IT-35131 Padova, Italy
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28
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Pizzolato C, Reggiani M, Saxby DJ, Ceseracciu E, Modenese L, Lloyd DG. Biofeedback for Gait Retraining Based on Real-Time Estimation of Tibiofemoral Joint Contact Forces. IEEE Trans Neural Syst Rehabil Eng 2017; 25:1612-1621. [PMID: 28436878 DOI: 10.1109/tnsre.2017.2683488] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Biofeedback assisted rehabilitation and intervention technologies have the potential to modify clinically relevant biomechanics. Gait retraining has been used to reduce the knee adduction moment, a surrogate of medial tibiofemoral joint loading often used in knee osteoarthritis research. In this paper, we present an electromyogram-driven neuromusculoskeletal model of the lower-limb to estimate, in real-time, the tibiofemoral joint loads. The model included 34 musculotendon units spanning the hip, knee, and ankle joints. Full-body inverse kinematics, inverse dynamics, and musculotendon kinematics were solved in real-time from motion capture and force plate data to estimate the knee medial tibiofemoral contact force (MTFF). We analyzed five healthy subjects while they were walking on an instrumented treadmill with visual biofeedback of their MTFF. Each subject was asked to modify their gait in order to vary the magnitude of their MTFF. All subjects were able to increase their MTFF, whereas only three subjects could decrease it, and only after receiving verbal suggestions about possible gait modification strategies. Results indicate the important role of knee muscle activation patterns in modulating the MTFF. While this paper focused on the knee, the technology can be extended to examine the musculoskeletal tissue loads at different sites of the human body.
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Kainz H, Hajek M, Modenese L, Saxby DJ, Lloyd DG, Carty CP. Reliability of functional and predictive methods to estimate the hip joint centre in human motion analysis in healthy adults. Gait Posture 2017; 53:179-184. [PMID: 28171844 DOI: 10.1016/j.gaitpost.2017.01.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 01/21/2017] [Accepted: 01/24/2017] [Indexed: 02/02/2023]
Abstract
In human motion analysis predictive or functional methods are used to estimate the location of the hip joint centre (HJC). It has been shown that the Harrington regression equations (HRE) and geometric sphere fit (GSF) method are the most accurate predictive and functional methods, respectively. To date, the comparative reliability of both approaches has not been assessed. The aims of this study were to (1) compare the reliability of the HRE and the GSF methods, (2) analyse the impact of the number of thigh markers used in the GSF method on the reliability, (3) evaluate how alterations to the movements that comprise the functional trials impact HJC estimations using the GSF method, and (4) assess the influence of the initial guess in the GSF method on the HJC estimation. Fourteen healthy adults were tested on two occasions using a three-dimensional motion capturing system. Skin surface marker positions were acquired while participants performed quite stance, perturbed and non-perturbed functional trials, and walking trials. Results showed that the HRE were more reliable in locating the HJC than the GSF method. However, comparison of inter-session hip kinematics during gait did not show any significant difference between the approaches. Different initial guesses in the GSF method did not result in significant differences in the final HJC location. The GSF method was sensitive to the functional trial performance and therefore it is important to standardize the functional trial performance to ensure a repeatable estimate of the HJC when using the GSF method.
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Affiliation(s)
- Hans Kainz
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
| | - Martin Hajek
- Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; University of Applied Sciences Technikum Wien, Vienna, Austria.
| | - Luca Modenese
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Department of Mechanical Engineering, University of Sheffield, United Kingdom; INSIGNEO Institute for in Silico Medicine, The University of Sheffield, United Kingdom.
| | - David J Saxby
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - David G Lloyd
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Christopher P Carty
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
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Sartori M, Fernandez JW, Modenese L, Carty CP, Barber LA, Oberhofer K, Zhang J, Handsfield GG, Stott NS, Besier TF, Farina D, Lloyd DG. Toward modeling locomotion using electromyography-informed 3D models: application to cerebral palsy. WIREs Syst Biol Med 2016; 9. [DOI: 10.1002/wsbm.1368] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 10/11/2016] [Accepted: 10/18/2016] [Indexed: 01/17/2023]
Affiliation(s)
- M. Sartori
- Department of Trauma Surgery; Orthopedics and Plastic Surgery, Neurorehabilitation Systems Research Group, University Medical Center Göttingen; Göttingen Germany
| | - J. W. Fernandez
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
- Department of Engineering Science; University of Auckland; Auckland New Zealand
| | - L. Modenese
- Department of Mechanical Engineering; The University of Sheffield; Sheffield UK
- Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service; Children's Health Queensland; Brisbane Australia
- Menzies Health Institute Queensland; Griffith University; Queensland Australia
| | - C. P. Carty
- Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service; Children's Health Queensland; Brisbane Australia
- Menzies Health Institute Queensland; Griffith University; Queensland Australia
- School of Allied Health Sciences; Griffith University; Queensland Australia
| | - L. A. Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine; The University of Queensland; Brisbane Australia
| | - K. Oberhofer
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
| | - J. Zhang
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
| | - G. G. Handsfield
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
| | - N. S. Stott
- School of Medicine; University of Auckland; Auckland New Zealand
| | - T. F. Besier
- Auckland Bioengineering Institute; University of Auckland; Auckland New Zealand
- Department of Engineering Science; University of Auckland; Auckland New Zealand
| | - D. Farina
- Department of Bioengineering; Imperial College London; London UK
| | - D. G. Lloyd
- Menzies Health Institute Queensland; Griffith University; Queensland Australia
- School of Allied Health Sciences; Griffith University; Queensland Australia
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Pizzolato C, Reggiani M, Modenese L, Lloyd DG. Real-time inverse kinematics and inverse dynamics for lower limb applications using OpenSim. Comput Methods Biomech Biomed Engin 2016; 20:436-445. [PMID: 27723992 DOI: 10.1080/10255842.2016.1240789] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Real-time estimation of joint angles and moments can be used for rapid evaluation in clinical, sport, and rehabilitation contexts. However, real-time calculation of kinematics and kinetics is currently based on approximate solutions or generic anatomical models. We present a real-time system based on OpenSim solving inverse kinematics and dynamics without simplifications at 2000 frame per seconds with less than 31.5 ms of delay. We describe the software architecture, sensitivity analyses to minimise delays and errors, and compare offline and real-time results. This system has the potential to strongly impact current rehabilitation practices enabling the use of personalised musculoskeletal models in real-time.
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Affiliation(s)
- C Pizzolato
- a School of Allied Health Sciences and Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
| | - M Reggiani
- b Department of Management and Engineering , University of Padua , Vicenza , Italy
| | - L Modenese
- a School of Allied Health Sciences and Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia.,c Department of Mechanical Engineering , University of Sheffield , Sheffield , UK.,d INSIGNEO Institute for in silico Medicine , University of Sheffield , Sheffield , UK
| | - D G Lloyd
- a School of Allied Health Sciences and Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
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Kainz H, Modenese L, Lloyd D, Maine S, Walsh H, Carty C. Joint kinematic calculation based on clinical direct kinematic versus inverse kinematic gait models. J Biomech 2016; 49:1658-1669. [DOI: 10.1016/j.jbiomech.2016.03.052] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 12/31/2015] [Accepted: 03/28/2016] [Indexed: 11/28/2022]
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Geraldes DM, Modenese L, Phillips ATM. Consideration of multiple load cases is critical in modelling orthotropic bone adaptation in the femur. Biomech Model Mechanobiol 2015; 15:1029-42. [PMID: 26578078 PMCID: PMC5021760 DOI: 10.1007/s10237-015-0740-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/19/2015] [Indexed: 11/02/2022]
Abstract
Functional adaptation of the femur has been investigated in several studies by embedding bone remodelling algorithms in finite element (FE) models, with simplifications often made to the representation of bone's material symmetry and mechanical environment. An orthotropic strain-driven adaptation algorithm is proposed in order to predict the femur's volumetric material property distribution and directionality of its internal structures within a continuum. The algorithm was applied to a FE model of the femur, with muscles, ligaments and joints included explicitly. Multiple load cases representing distinct frames of two activities of daily living (walking and stair climbing) were considered. It is hypothesised that low shear moduli occur in areas of bone that are simply loaded and high shear moduli in areas subjected to complex loading conditions. In addition, it is investigated whether material properties of different femoral regions are stimulated by different activities. The loading and boundary conditions were considered to provide a physiological mechanical environment. The resulting volumetric material property distribution and directionalities agreed with ex vivo imaging data for the whole femur. Regions where non-orthogonal trabecular crossing has been documented coincided with higher values of predicted shear moduli. The topological influence of the different activities modelled was analysed. The influence of stair climbing on the properties of the femoral neck region is highlighted. It is recommended that multiple load cases should be considered when modelling bone adaptation. The orthotropic model of the complete femur is released with this study.
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Affiliation(s)
- Diogo M Geraldes
- Structural Biomechanics, Department of Civil and Environmental Engineering, Skempton Building, Imperial College London, London, UK. .,Biomechanics Group, Department of Mechanical Engineering, City and Guilds Building, Imperial College London, London, UK.
| | - Luca Modenese
- Structural Biomechanics, Department of Civil and Environmental Engineering, Skempton Building, Imperial College London, London, UK.,Department of Mechanical Engineering, Sir Frederick Mappin Building, Mappin Street, The University of Sheffield, Sheffield, UK.,INSIGNEO Institute for In Silico Medicine, The Pam Liversidge Building, The University of Sheffield, Sheffield, UK
| | - Andrew T M Phillips
- Structural Biomechanics, Department of Civil and Environmental Engineering, Skempton Building, Imperial College London, London, UK
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Kainz H, Carty CP, Modenese L, Boyd RN, Lloyd DG. Estimation of the hip joint centre in human motion analysis: a systematic review. Clin Biomech (Bristol, Avon) 2015; 30:319-29. [PMID: 25753697 DOI: 10.1016/j.clinbiomech.2015.02.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Inaccuracies in locating the three-dimensional position of the hip joint centre affect the calculated hip and knee kinematics, force- and moment-generating capacity of muscles and hip joint mechanics, which can lead to incorrect interpretations and recommendations in gait analysis. Several functional and predictive methods have been developed to estimate the hip joint centre location, and the International Society of Biomechanics recommends a functional approach for use with participants that have adequate range of motion at the hip, and predictive methods in those with insufficient range of motion. The purpose of the current systematic review was to substantiate the International Society of Biomechanics recommendations. This included identifying the most accurate functional and predictive methods, and defining 'adequate' range of motion. METHODS A systematic search with broad search terms was performed including five databases. FINDINGS The systematic search yielded to 801 articles, of which 34 papers were included. Eleven different predictive and 13 different functional methods were identified. The results showed that the geometric sphere fit method and Harrington equations are the most accurate functional and predictive approaches respectively that have been evaluated in vivo. INTERPRETATION In regard to the International Society of Biomechanics recommendations, the geometric sphere fit method should be used in people with sufficient active hip range of motion and the Harrington equations should be used in patients without sufficient hip range of motion. Multi-plane movement trials with at least 60° of flexion-extension and 30° of ab-adduction range of motion are suggested when using functional methods.
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Affiliation(s)
- Hans Kainz
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Gait Laboratory, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
| | - Christopher P Carty
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Gait Laboratory, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Luca Modenese
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
| | - David G Lloyd
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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Phillips AT, Villette CC, Modenese L. Femoral bone mesoscale structural architecture prediction using musculoskeletal and finite element modelling. Int Biomech 2015. [DOI: 10.1080/23335432.2015.1017609] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Gopalakrishnan A, Modenese L, Phillips ATM. A novel computational framework for deducing muscle synergies from experimental joint moments. Front Comput Neurosci 2014; 8:153. [PMID: 25520645 PMCID: PMC4253955 DOI: 10.3389/fncom.2014.00153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 11/04/2014] [Indexed: 01/08/2023] Open
Abstract
Prior experimental studies have hypothesized the existence of a "muscle synergy" based control scheme for producing limb movements and locomotion in vertebrates. Such synergies have been suggested to consist of fixed muscle grouping schemes with the co-activation of all muscles in a synergy resulting in limb movement. Quantitative representations of these groupings (termed muscle weightings) and their control signals (termed synergy controls) have traditionally been derived by the factorization of experimentally measured EMG. This study presents a novel approach for deducing these weightings and controls from inverse dynamic joint moments that are computed from an alternative set of experimental measurements-movement kinematics and kinetics. This technique was applied to joint moments for healthy human walking at 0.7 and 1.7 m/s, and two sets of "simulated" synergies were computed based on two different criteria (1) synergies were required to minimize errors between experimental and simulated joint moments in a musculoskeletal model (pure-synergy solution) (2) along with minimizing joint moment errors, synergies also minimized muscle activation levels (optimal-synergy solution). On comparing the two solutions, it was observed that the introduction of optimality requirements (optimal-synergy) to a control strategy solely aimed at reproducing the joint moments (pure-synergy) did not necessitate major changes in the muscle grouping within synergies or the temporal profiles of synergy control signals. Synergies from both the simulated solutions exhibited many similarities to EMG derived synergies from a previously published study, thus implying that the analysis of the two different types of experimental data reveals similar, underlying synergy structures.
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Affiliation(s)
- Anantharaman Gopalakrishnan
- The Royal British Legion Centre for Blast Injury Studies at Imperial College London London, UK ; Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College London London, UK
| | - Luca Modenese
- Griffith Health Institute, Centre for Musculoskeletal Research, Griffith University Gold Coast, QLD, Australia
| | - Andrew T M Phillips
- The Royal British Legion Centre for Blast Injury Studies at Imperial College London London, UK ; Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College London London, UK
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Pizzolato C, Reggiani M, Modenese L, Lloyd D. Real-time estimation of lower limb joint angles through inverse kinematics during walking using a scaled OpenSim model. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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van Arkel RJ, Modenese L, Phillips ATM, Jeffers JRT. Hip abduction can prevent posterior edge loading of hip replacements. J Orthop Res 2013; 31:1172-9. [PMID: 23575923 PMCID: PMC3736148 DOI: 10.1002/jor.22364] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 03/11/2013] [Indexed: 02/04/2023]
Abstract
Edge loading causes clinical problems for hard-on-hard hip replacements, and edge loading wear scars are present on the majority of retrieved components. We asked the question: are the lines of action of hip joint muscles such that edge loading can occur in a well-designed, well-positioned acetabular cup? A musculoskeletal model, based on cadaveric lower limb geometry, was used to calculate for each muscle, in every position within the complete range of motion, whether its contraction would safely pull the femoral head into the cup or contribute to edge loading. The results show that all the muscles that insert into the distal femur, patella, or tibia could cause edge loading of a well-positioned cup when the hip is in deep flexion. Patients frequently use distally inserting muscles for movements requiring deep hip flexion, such as sit-to-stand. Importantly, the results, which are supported by in vivo data and clinical findings, also show that risk of edge loading is dramatically reduced by combining deep hip flexion with hip abduction. Patients, including those with sub-optimally positioned cups, may be able to reduce the prevalence of edge loading by rising from chairs or stooping with the hip abducted.
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Affiliation(s)
- Richard J van Arkel
- Medical Engineering, Department of Mechanical Engineering, Imperial College LondonLondon, SW7 2AZ, United Kingdom
| | - Luca Modenese
- Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College LondonLondon, United Kingdom,Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold CoastQueensland, Australia
| | - Andrew TM Phillips
- Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College LondonLondon, United Kingdom
| | - Jonathan RT Jeffers
- Medical Engineering, Department of Mechanical Engineering, Imperial College LondonLondon, SW7 2AZ, United Kingdom
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Modenese L, Phillips A, Bull A. An open source lower limb model: Hip joint validation. J Biomech 2011; 44:2185-93. [DOI: 10.1016/j.jbiomech.2011.06.019] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 06/06/2011] [Accepted: 06/15/2011] [Indexed: 11/16/2022]
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