scholarly journals A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment

Author(s):  
Jana Holder ◽  
Ursula Trinler ◽  
Andrea Meurer ◽  
Felix Stief

The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1306
Author(s):  
Claude Fiifi Hayford ◽  
Emma Pratt ◽  
John P. Cashman ◽  
Owain G. Evans ◽  
Claudia Mazzà

Multibody optimisation approaches have not seen much use in routine clinical applications despite evidence of improvements in modelling through a reduction in soft tissue artifacts compared to the standard gait analysis technique of direct kinematics. To inform clinical use, this study investigated the consistency with which both approaches predicted post-surgical outcomes, using changes in Gait Profile Score (GPS) when compared to a clinical assessment of outcome that did not include the 3D gait data. Retrospective three-dimensional motion capture data were utilised from 34 typically developing children and 26 children with cerebral palsy who underwent femoral derotation osteotomies as part of Single Event Multi-Level Surgeries. Results indicated that while, as expected, the GPS estimated from the two methods were numerically different, they were strongly correlated (Spearman’s ρ = 0.93), and no significant differences were observed between their estimations of change in GPS after surgery. The two scores equivalently classified a worsening or improvement in the gait quality in 93% of the cases. When compared with the clinical classification of responders versus non-responders to the intervention, an equivalent performance was found for the two approaches, with 27/41 and 28/41 cases in agreement with the clinical judgement for multibody optimisation and direct kinematics, respectively. With this equivalent performance to the direct kinematics approach and the benefit of being less sensitive to skin artefact and allowing additional analysis such as estimation of musculotendon lengths and joint contact forces, multibody optimisation has the potential to improve the clinical decision-making process in children with cerebral palsy.


2013 ◽  
Vol 135 (2) ◽  
Author(s):  
Kurt Manal ◽  
Thomas S. Buchanan

Computational models that predict internal joint forces have the potential to enhance our understanding of normal and pathological movement. Validation studies of modeling results are necessary if such models are to be adopted by clinicians to complement patient treatment and rehabilitation. The purposes of this paper are: (1) to describe an electromyogram (EMG)-driven modeling approach to predict knee joint contact forces, and (2) to evaluate the accuracy of model predictions for two distinctly different gait patterns (normal walking and medial thrust gait) against known values for a patient with a force recording knee prosthesis. Blinded model predictions and revised model estimates for knee joint contact forces are reported for our entry in the 2012 Grand Challenge to predict in vivo knee loads. The EMG-driven model correctly predicted that medial compartment contact force for the medial thrust gait increased despite the decrease in knee adduction moment. Model accuracy was high: the difference in peak loading was less than 0.01 bodyweight (BW) with an R2 = 0.92. The model also predicted lateral loading for the normal walking trial with good accuracy exhibiting a peak loading difference of 0.04 BW and an R2 = 0.44. Overall, the EMG-driven model captured the general shape and timing of the contact force profiles and with accurate input data the model estimated joint contact forces with sufficient accuracy to enhance the interpretation of joint loading beyond what is possible from data obtained from standard motion capture studies.


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2960 ◽  
Author(s):  
Ross H. Miller ◽  
Rebecca L. Krupenevich ◽  
Alison L. Pruziner ◽  
Erik J. Wolf ◽  
Barri L. Schnall

BackgroundIndividuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss.MethodsCross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW).ResultsPeak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters.DiscussionAssuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.


2021 ◽  
Author(s):  
Martin Huber ◽  
Matthew Eschbach ◽  
Kazem Kazerounian ◽  
Horea T. Ilies

Abstract Knee osteoarthritis (OA) is a disease that compromises the cartilage inside the knee joint, resulting in pain and impaired mobility. Bracing is a common treatment, however currently prescribed braces cannot treat bicompartmental knee OA, fail to consider the muscle weakness that typically accompanies the disease, and utilize hinges that restrict the knee's natural biomechanics. We have developed and evaluated a brace which addresses these shortcomings. This process has respected three principal design goals: reducing the load experienced across the entire knee joint, generating a supportive moment to aid the muscles in shock absorption, and interfering minimally with gait kinematics. Load reduction is achieved via the compression of medial and lateral leaf springs, and magnetorheological dampers provide the supportive moment during knee loading. A novel, personalized joint mechanism replaces a traditional hinge to reduce interference with knee kinematics. Using motion capture gait analysis, we evaluated the basic functionality of a prototype device. We calculated, via inverse dynamics analysis, the reaction forces at the knee joint and the moments generated by the leg muscles during gait. Comparing these values between braced and unbraced trials allowed us to evaluate the system's effectiveness. Kinematic measurements showed the extent to which the brace interfered with natural gait characteristics. Of the three design goals: a reduction in knee contact forces was demonstrated; increased shock absorption was observed, but not to statistical significance; and natural gait was largely preserved. The techniques presented in this paper could lead to improved OA treatment through patient-specific braces.


Author(s):  
Allison L. Kinney ◽  
Heather K. Vincent ◽  
Melinda K. Harman ◽  
James Coburn ◽  
Darryl D. D’Lima ◽  
...  

Obesity is commonly considered a risk factor for the development of knee osteoarthritis [1]. Previous studies have shown that reductions in body weight correspond to reductions in total knee joint compressive forces (as calculated by inverse dynamics) [2–4]. A recent study showed that external knee load measurements are not strong predictors of internal knee contact forces [5]. Therefore, direct measurement of knee contact force is important for understanding how body weight changes impact knee joint loading. Force-measuring knee implants can directly measure internal knee contact forces [6].


2018 ◽  
Vol 34 (5) ◽  
pp. 419-423 ◽  
Author(s):  
Christopher M. Saliba ◽  
Allison L. Clouthier ◽  
Scott C.E. Brandon ◽  
Michael J. Rainbow ◽  
Kevin J. Deluzio

Abnormal loading of the knee joint contributes to the pathogenesis of knee osteoarthritis. Gait retraining is a noninvasive intervention that aims to reduce knee loads by providing audible, visual, or haptic feedback of gait parameters. The computational expense of joint contact force prediction has limited real-time feedback to surrogate measures of the contact force, such as the knee adduction moment. We developed a method to predict knee joint contact forces using motion analysis and a statistical regression model that can be implemented in near real-time. Gait waveform variables were deconstructed using principal component analysis, and a linear regression was used to predict the principal component scores of the contact force waveforms. Knee joint contact force waveforms were reconstructed using the predicted scores. We tested our method using a heterogenous population of asymptomatic controls and subjects with knee osteoarthritis. The reconstructed contact force waveforms had mean (SD) root mean square differences of 0.17 (0.05) bodyweight compared with the contact forces predicted by a musculoskeletal model. Our method successfully predicted subject-specific shape features of contact force waveforms and is a potentially powerful tool in biofeedback and clinical gait analysis.


2014 ◽  
Vol 22 ◽  
pp. S86-S87 ◽  
Author(s):  
E. Wellsandt ◽  
E. Gardinier ◽  
K. Manal ◽  
M. Axe ◽  
T. Buchanan ◽  
...  

Author(s):  
Hannah J. Lundberg ◽  
Markus A. Wimmer

Detailed knowledge of in vivo knee contact forces and the contribution from muscles, ligaments, and other soft-tissues to knee joint function are essential for evaluating total knee replacement (TKR) designs. We have recently developed a mathematical model for calculating knee joint contact forces using parametric methodology (Lundberg et al., 2009). The numerical model calculates a “solution space” of three-dimensional contact forces for both the medial and lateral compartments of the tibial plateau. The solution spaces are physiologically meaningful, and represent the result of balancing the external moments and forces by different strategies.


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