Dependency of lower limb joint reaction forces on femoral version

Modenese, Luca; Barzan, Martina; Carty, Christopher P.

doi:10.1016/j.gaitpost.2021.06.014

Cited by 31 publications

(32 citation statements)

References 14 publications

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“…As a result, even personalized models have an inherent uncertainty in their muscle geometry representation. Moreover, other sources of inter-subject variability such as bone geometry (e.g., femoral anteversion angle or tibial torsion) may also influence the muscle attachment points and pathway geometry, thereby impacting the predicted KCFs (Kainz et al, 2020;Modenese et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…It is also important to mention that our probabilistic approach did not account for inter-subject variability of bone geometry. Such variations can impact the 3D pathways of the muscles and thereby the joint contact force estimation (Kainz et al, 2020;Modenese et al, 2021). More importantly, we only used SO to solve the muscle redundancy problem through minimizing the sum of the squared muscle activation levels.…”

Section: Discussionmentioning

confidence: 99%

“…To represent a specific subject, certain model parameters are usually scaled based on the individual's weight and skin marker locations in a static pose (Kainz et al, 2017;Imani Nejad et al, 2020;Ma et al, 2021). However, the scaled parameters possess inherent uncertainty due to marker placement inaccuracy, on top of considerable inter-subject variability due to skeletal morphology, for example, femoral anteversion angle (Kainz et al, 2021;Modenese et al, 2021) and muscle parameters, for example, tendon slack length (Winby et al, 2008;Heinen et al, 2016). As a result, the importance of using subject-specific muscle parameters to reduce uncertainty in modeling outcomes has been consistently emphasized in the literature (Barry et al, 2010;Gerus et al, 2013;Myers et al, 2015;Chen et al, 2016;Koller et al, 2021), but such parameters are generally difficult to measure.…”

Section: Introductionmentioning

confidence: 99%

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Uncertainty in Muscle–Tendon Parameters can Greatly Influence the Accuracy of Knee Contact Force Estimates of Musculoskeletal Models

Nasab

Maas

et al. 2022

Front. Bioeng. Biotechnol.

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Understanding the sources of error is critical before models of the musculoskeletal system can be usefully translated. Using in vivo measured tibiofemoral forces, the impact of uncertainty in muscle–tendon parameters on the accuracy of knee contact force estimates of a generic musculoskeletal model was investigated following a probabilistic approach. Population variability was introduced to the routine musculoskeletal modeling framework by perturbing input parameters of the lower limb muscles around their baseline values. Using ground reaction force and skin marker trajectory data collected from six subjects performing body-weight squat, the knee contact force was calculated for the perturbed models. The combined impact of input uncertainties resulted in a considerable variation in the knee contact force estimates (up to 2.1 BW change in the predicted force), especially at larger knee flexion angles, hence explaining up to 70% of the simulation error. Although individual muscle groups exhibited different contributions to the overall error, variation in the maximum isometric force and pathway of the muscles showed the highest impacts on the model outcomes. Importantly, this study highlights parameters that should be personalized in order to achieve the best possible predictions when using generic musculoskeletal models for activities involving deep knee flexion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Uncertainty in Muscle–Tendon Parameters can Greatly Influence the Accuracy of Knee Contact Force Estimates of Musculoskeletal Models

Nasab

Maas

et al. 2022

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

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“…However, due to the reduced number of markers on the foot segment, the motions of the ankle joint complex were simplified by neglecting subtalar inversion and eversion, which could affect the prediction of muscle activations ( Jinha et al, 2006 ). Additionally, bone morphology variability in the transversal and frontal planes could also affect the prediction of muscle activations and forces ( Passmore et al, 2018 ; Kainz et al, 2020 ; Martelli et al, 2020 ; De Pieri et al, 2021 ; Modenese et al, 2021 ; Veerkamp et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Altered Muscle Contributions are Required to Support the Stance Limb During Voluntary Toe-Walking

Pieri

Romkes

Wyss

et al. 2022

Front. Bioeng. Biotechnol.

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Toe-walking characterizes several neuromuscular conditions and is associated with a reduction in gait stability and efficiency, as well as in life quality. The optimal choice of treatment depends on a correct understanding of the underlying pathology and on the individual biomechanics of walking. The objective of this study was to describe gait deviations occurring in a cohort of healthy adult subjects when mimicking a unilateral toe-walking pattern compared to their normal heel-to-toe gait pattern. The focus was to characterize the functional adaptations of the major lower-limb muscles which are required in order to toe walk. Musculoskeletal modeling was used to estimate the required muscle contributions to the joint sagittal moments. The support moment, defined as the sum of the sagittal extensive moments at the ankle, knee, and hip joints, was used to evaluate the overall muscular effort necessary to maintain stance limb stability and prevent the collapse of the knee. Compared to a normal heel-to-toe gait pattern, toe-walking was characterized by significantly different lower-limb kinematics and kinetics. The altered kinetic demands at each joint translated into different necessary moment contributions from most muscles. In particular, an earlier and prolonged ankle plantarflexion contribution was required from the soleus and gastrocnemius during most of the stance phase. The hip extensors had to provide a higher extensive moment during loading response, while a significantly higher knee extension contribution from the vasti was necessary during mid-stance. Compensatory muscular activations are therefore functionally required at every joint level in order to toe walk. A higher support moment during toe-walking indicates an overall higher muscular effort necessary to maintain stance limb stability and prevent the collapse of the knee. Higher muscular demands during gait may lead to fatigue, pain, and reduced quality of life. Toe-walking is indeed associated with significantly larger muscle forces exerted by the quadriceps to the patella and prolonged force transmission through the Achilles tendon during stance phase. Optimal treatment options should therefore account for muscular demands and potential overloads associated with specific compensatory mechanisms.

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“…Nonetheless, this study attempted to approximate some aspect of personalisation in the mGen model, adapting the model to use the knee axis orientation defined with the KAD. An alternative approach of deforming the generic model using clinical measures of femoral anteversion has been proposed [36][37][38]; however, given that this was a retrospective study, these metrics were not available for most participants and control data and thus could not be implemented. It is also recognised that using the consensus clinical judgement with no gait analysis metrics input as a proxy gold standard is by nature subjective, and this may have introduced additional error.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Global Optimisation and Direct Kinematics in Predicting Surgical Outcome in Children with Cerebral Palsy

Hayford

Pratt

Cashman

et al. 2021

Life

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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.

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Dependency of lower limb joint reaction forces on femoral version

Cited by 31 publications

References 14 publications

Uncertainty in Muscle–Tendon Parameters can Greatly Influence the Accuracy of Knee Contact Force Estimates of Musculoskeletal Models

Uncertainty in Muscle–Tendon Parameters can Greatly Influence the Accuracy of Knee Contact Force Estimates of Musculoskeletal Models

Altered Muscle Contributions are Required to Support the Stance Limb During Voluntary Toe-Walking

Effectiveness of Global Optimisation and Direct Kinematics in Predicting Surgical Outcome in Children with Cerebral Palsy

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