Darryl G. Thelen

OpenSim: Open-Source Software to Create and Analyze Dynamic Simulations of Movement

Dynamic simulations of movement allow one to study neuromuscular coordination, analyze athletic performance, and estimate internal loading of the musculoskeletal system. Simulations can also be used to identify the sources of pathological movement and establish a scientific basis for treatment planning. We have developed a freely available, open-source software system (OpenSim) that lets users develop models of musculoskeletal structures and create dynamic simulations of a wide variety of movements. We are using this system to simulate the dynamics of individuals with pathological gait and to explore the biomechanical effects of treatments. OpenSim provides a platform on which the biomechanics community can build a library of simulations that can be exchanged, tested, analyzed, and improved through a multi-institutional collaboration. Developing software that enables a concerted effort from many investigators poses technical and sociological challenges. Meeting those challenges will accelerate the discovery of principles that govern movement control and improve treatments for individuals with movement pathologies.

Generating dynamic simulations of movement using computed muscle control

Computation of muscle excitation patterns that produce coordinated movements of muscle-actuated dynamic models is an important and challenging problem. Using dynamic optimization to compute excitation patterns comes at a large computational cost, which has limited the use of muscle-actuated simulations. This paper introduces a new algorithm, which we call computed muscle control, that uses static optimization along with feedforward and feedback controls to drive the kinematic trajectory of a musculoskeletal model toward a set of desired kinematics. We illustrate the algorithm by computing a set of muscle excitations that drive a 30-muscle, 3-degree-of-freedom model of pedaling to track measured pedaling kinematics and forces. Only 10 min of computer time were required to compute muscle excitations that reproduced the measured pedaling dynamics, which is over two orders of magnitude faster than conventional dynamic optimization techniques. Simulated kinematics were within 1 degrees of experimental values, simulated pedal forces were within one standard deviation of measured pedal forces for nearly all of the crank cycle, and computed muscle excitations were similar in timing to measured electromyographic patterns. The speed and accuracy of this new algorithm improves the feasibility of using detailed musculoskeletal models to simulate and analyze movement.

Adjustment of Muscle Mechanics Model Parameters to Simulate Dynamic Contractions in Older Adults

The generation of muscle-actuated simulations that accurately represent the movement of old adults requires a model that accounts for changes in muscle properties that occur with aging. An objective of this study was to adjust the parameters of Hill-type musculo-tendon models to reflect nominal age-related changes in muscle mechanics that have been reported in the literature. A second objective was to determine whether using the parametric adjustments resulted in simulated dynamic ankle torque behavior similar to that seen in healthy old adults. The primary parameter adjustment involved decreasing maximum isometric muscle forces to account for the loss of muscle mass and specific strength with age. A review of the literature suggested the need for other modest adjustments that account for prolonged muscular deactivation, a reduction in maximum contraction velocity, greater passive muscle stiffness and increased normalized force capacity during lengthening contractions. With age-related changes incorporated, a musculo-tendon model was used to simulate isometric and isokinetic contractions of ankle plantarflexor and dorsiflexor muscles. The model predicted that ankle plantarflexion power output during 120 deg/s shortening contractions would be over 40% lower in old adults compared to healthy young adults. These power losses with age exceed the 30% loss in isometric strength assumed in the model but are comparable to 39-44% reductions in ankle power outputs measured in healthy old adults of approximately 70 years of age. Thus, accounting for age-related changes in muscle properties, other than decreased maximum isometric force, may be particularly important when simulating movements that require substantial power development.

Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention

UNLABELLED Hamstring strain injuries remain a challenge for both athletes and clinicians, given their high incidence rate, slow healing, and persistent symptoms. Moreover, nearly one third of these injuries recur within the first year following a return to sport, with subsequent injuries often being more severe than the original. This high reinjury rate suggests that commonly utilized rehabilitation programs may be inadequate at resolving possible muscular weakness, reduced tissue extensibility, and/or altered movement patterns associated with the injury. Further, the traditional criteria used to determine the readiness of the athlete to return to sport may be insensitive to these persistent deficits, resulting in a premature return. There is mounting evidence that the risk of reinjury can be minimized by utilizing rehabilitation strategies that incorporate neuromuscular control exercises and eccentric strength training, combined with objective measures to assess musculotendon recovery and readiness to return to sport. In this paper, we first describe the diagnostic examination of an acute hamstring strain injury, including discussion of the value of determining injury location in estimating the duration of the convalescent period. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring injuries, including specific criteria for treatment progression and return to sport. Finally, we describe directions for future research, including injury-specific rehabilitation programs, objective measures to assess reinjury risk, and strategies to prevent injury occurrence. LEVEL OF EVIDENCE Diagnosis/therapy/prevention, level 5.

Hamstring muscle kinematics during treadmill sprinting.

INTRODUCTION/PURPOSE The objective of this study was to characterize hamstring muscle kinematics during sprinting, so as to provide scientific data to better understand injury mechanisms and differences in injury rates between muscles. METHODS We conducted three-dimensional motion analyses of 14 athletes performing treadmill sprinting at speeds ranging from 80 to 100% of maximum. Scaled musculoskeletal models were used to estimate hamstring muscle-tendon lengths throughout the sprinting gait cycle for each speed. We tested the hypothesis that the biceps femoris (BF) long head would be stretched a greater amount, relative to its length in an upright posture, than the semitendinosus (ST) and semimembranosus (SM). We also tested the hypothesis that increasing from submaximal to maximal sprinting speed would both increase the magnitude and delay the occurrence of peak muscle-tendon length in the gait cycle. RESULTS Maximum hamstring lengths occurred during the late swing phase of sprinting and were an average of 7.4% (SM), 8.1% (ST), and 9.5% (BF) greater than the respective muscle-tendon lengths in an upright configuration. Peak lengths were significantly larger in the BF than the ST and SM (P < 0.01), occurred significantly later in the gait cycle at the maximal speed (P < 0.01), but did not increase significantly with speed. Differences in the hip extension and knee flexion moment arms between the biarticular hamstrings account for the intermuscle variations in the peak lengths that were estimated. CONCLUSIONS We conclude that intermuscle differences in hamstring moment arms about the hip and knee may be a factor contributing to the greater propensity for hamstring strain injuries to occur in the BF muscle.

Differences in lower-extremity muscular activation during walking between healthy older and young adults

Previous studies have identified differences in gait kinetics between healthy older and young adults. However, the underlying factors that cause these changes are not well understood. The objective of this study was to assess the effects of age and speed on the activation of lower-extremity muscles during human walking. We recorded electromyography (EMG) signals of the soleus, gastrocnemius, biceps femoris, medial hamstrings, tibialis anterior, vastus lateralis, and rectus femoris as healthy young and older adults walked over ground at slow, preferred and fast walking speeds. Nineteen healthy older adults (age, 73+/-5 years) and 18 healthy young adults (age, 26+/-3 years) participated. Rectified EMG signals were normalized to mean activities over a gait cycle at the preferred speed, allowing for an assessment of how the activity was distributed over the gait cycle and modulated with speed. Compared to the young adults, the older adults exhibited greater activation of the tibialis anterior and soleus during mid-stance at all walking speeds and greater activation of the vastus lateralis and medial hamstrings during loading and mid-stance at the fast walking speed, suggesting increased coactivation across the ankle and knee. In addition, older adults depend less on soleus muscle activation to push off at faster walking speeds. We conclude that age-related changes in neuromuscular activity reflect a strategy of stiffening the limb during single support and likely contribute to reduced push off power at fast walking speeds.

Hamstring Musculotendon Dynamics during Stance and Swing Phases of High Speed Running

INTRODUCTION Hamstring strain injuries are common in sports that involve high-speed running. It remains uncertain whether the hamstrings are susceptible to injury during late swing phase, when the hamstrings are active and lengthening, or during stance, when contact loads are present. In this study, we used forward dynamic simulations to compare hamstring musculotendon stretch, loading, and work done during stance and swing phases of high-speed running. METHODS Whole-body kinematics, EMG activities, and ground reactions were collected as 12 subjects ran on an instrumented treadmill at speeds ranging from 80% to 100% of maximum (avg max speed = 7.8 m·s(-1)). Subject-specific simulations were then created using a whole-body musculoskeletal model that included 52 Hill-type musculotendon units acting about the hip and the knee. A computed muscle control algorithm was used to determine muscle excitation patterns that drove the limb to track measured hip and knee sagittal plane kinematics, with measured ground reactions applied to the limb. RESULTS The hamstrings lengthened under load from 50% to 90% of the gait cycle (swing) and then shortened under load from late swing through stance. Although peak hamstring stretch was invariant with speed, lateral hamstring (biceps femoris) loading increased significantly with speed and was greater during swing than stance at the fastest speed. The biarticular hamstrings performed negative work on the system only during swing phase, with the amount of negative work increased significantly with speed. CONCLUSION We concluded that the large inertial loads during high-speed running appear to make the hamstrings most susceptible to injury during swing phase. This information is relevant for scientifically establishing muscle injury prevention and rehabilitation programs.

Active and passive contributions to joint kinetics during walking in older adults

The objectives of this study were to characterize the active and passive contributions to joint kinetics during walking in healthy young and older adults, and assess whether isokinetic ankle strength is associated with ankle power output during walking. Twenty healthy young (18-35 years) and 20 healthy older (65-85 years) adults participated in this study. We measured subject-specific passive-elastic joint moment-angle relationships in the lower extremity and tested maximum isokinetic ankle strength at 30 deg/s. Passive moment-angle relationships were used to estimate active and passive joint moment, power, and work quantities during walking at 80%, 100% and 120% of preferred walking speed. There were no significant differences in walking speed, step length, or cadence between the older and young adults. However, the older adults produced significantly more net positive work at the hip but less net positive work at the ankle at all walking speeds. Passive contributions to hip and ankle work did not significantly differ between groups, inferring that the older adults generated the additional hip work actively. Maximum isokinetic ankle strength was significantly less in the older adults, and correlated with peak positive plantar-flexor power at both the preferred and fast walking speeds. The results of this study suggest that age-related shifts in joint kinetics do not arise as a result of increased passive hip joint stiffness, but seem to be reflected in plantar-flexor weakness.

Self-Reported Walking Ability Predicts Functional Mobility Performance in Frail Older Adults

OBJECTIVE: To determine how self‐reported physical function relates to performance in each of three mobility domains: walking, stance maintenance, and rising from chairs.

Increasing Running Step Rate Reduces Patellofemoral Joint Forces

PURPOSE Increasing step rate has been shown to elicit changes in joint kinematics and kinetics during running, and it has been suggested as a possible rehabilitation strategy for runners with patellofemoral pain. The purpose of this study was to determine how altering step rate affects internal muscle forces and patellofemoral joint loads, and then to determine what kinematic and kinetic factors best predict changes in joint loading. METHODS We recorded whole body kinematics of 30 healthy adults running on an instrumented treadmill at three step rate conditions (90%, 100%, and 110% of preferred step rate). We then used a 3-D lower extremity musculoskeletal model to estimate muscle, patellar tendon, and patellofemoral joint forces throughout the running gait cycles. In addition, linear regression analysis allowed us to ascertain the relative influence of limb posture and external loads on patellofemoral joint force. RESULTS Increasing step rate to 110% of the preferred reduced peak patellofemoral joint force by 14%. Peak muscle forces were also altered as a result of the increased step rate with hip, knee, and ankle extensor forces, and hip abductor forces all reduced in midstance. Compared with the 90% step rate condition, there was a concomitant increase in peak rectus femoris and hamstring loads during early and late swing, respectively, at higher step rates. Peak stance phase knee flexion decreased with increasing step rate and was found to be the most important predictor of the reduction in patellofemoral joint loading. CONCLUSION Increasing step rate is an effective strategy to reduce patellofemoral joint forces and could be effective in modulating biomechanical factors that can contribute to patellofemoral pain.