Laurence Cheze

Influence of joint constraints on lower limb kinematics estimation from skin markers using global optimization

In order to obtain the lower limb kinematics from skin-based markers, the soft tissue artefact (STA) has to be compensated. Global optimization (GO) methods rely on a predefined kinematic model and attempt to limit STA by minimizing the differences between model predicted and skin-based marker positions. Thus, the reliability of GO methods depends directly on the chosen model, whose influence is not well known yet. This study develops a GO method that allows to easily implement different sets of joint constraints in order to assess their influence on the lower limb kinematics during gait. The segment definition was based on generalized coordinates giving only linear or quadratic joint constraints. Seven sets of joint constraints were assessed, corresponding to different kinematic models at the ankle, knee and hip: SSS, USS, PSS, SHS, SPS, UHS and PPS (where S, U and H stand for spherical, universal and hinge joints and P for parallel mechanism). GO was applied to gait data from five healthy males. Results showed that the lower limb kinematics, except hip kinematics, knee and ankle flexion-extension, significantly depend on the chosen ankle and knee constraints. The knee parallel mechanism generated some typical knee rotation patterns previously observed in lower limb kinematic studies. Furthermore, only the parallel mechanisms produced joint displacements. Thus, GO using parallel mechanism seems promising. It also offers some perspectives of subject-specific joint constraints.

Kinematic and kinetic comparisons of elite and well-trained sprinters during sprint start.

Slawinski, J, Bonnefoy, A, Levêque, JM, Ontanon, G, Riquet, A, Dumas, R, and Chèze, L. Kinematic and kinetic comparisons of elite and well-trained sprinters during sprint start. J Strength Cond Res 24(4): 896-905, 2010-The purpose of this study was to compare the main kinematic, kinetic, and dynamic parameters of elite and well-trained sprinters during the starting block phase and the 2 subsequent steps. Six elite sprinters (10.06-10.43 s/100 m) and 6 well-trained sprinters (11.01-11.80 s/100 m) equipped with 63 passive reflective markers performed 4 maximal 10 m sprint starts on an indoor track. An opto-electronic motion analysis system consisting of 12 digital cameras (250 Hz) was used to record 3D marker trajectories. At the times “on your marks,” “set,” “clearing the block,” and “landing and toe-off of the first and second step,” the horizontal position of the center of mass (CM), its velocity (XCM and VCM), and the horizontal position of the rear and front hand (XHand_rear and XHand_front) were calculated. During the pushing phase on the starting block and the 2 first steps, the rate of force development and the impulse (Fimpulse) were also calculated. The main results showed that at each time XCM and VCM were significantly greater in elite sprinters. Moreover, during the pushing phase on the block, the rate of force development and Fimpulse were significantly greater in elite sprinters (respectively, 15,505 ± 5,397 N·s−1 and 8,459 ± 3,811 N·s−1 for the rate of force development; 276.2 ± 36.0 N·s and 215.4 ± 28.5 N·s for Fimpulse, p ≤ 0.05). Finally, at the block clearing, elite sprinters showed a greater XHand_rear and XHand_front than well-trained sprinters (respectively, 0.07± 0.12 m and −0.27 ± 0.36 m for XHand_rear; 1.00 ± 0.14 m and 0.52 ± 0.27 m for XHand_front; p ≤ 0.05). The muscular strength and arm coordination appear to characterize the efficiency of the sprint start. To improve speed capacities of their athletes, coaches must include in their habitual training sessions of resistance training.

A 3D lower limb musculoskeletal model for simultaneous estimation of musculo-tendon, joint contact, ligament and bone forces during gait

Musculo-tendon forces and joint reaction forces are typically estimated using a two-step method, computing first the musculo-tendon forces by a static optimization procedure and then deducing the joint reaction forces from the force equilibrium. However, this method does not allow studying the interactions between musculo-tendon forces and joint reaction forces in establishing this equilibrium and the joint reaction forces are usually overestimated. This study introduces a new 3D lower limb musculoskeletal model based on a one-step static optimization procedure allowing simultaneous musculo-tendon, joint contact, ligament and bone forces estimation during gait. It is postulated that this approach, by giving access to the forces transmitted by these musculoskeletal structures at hip, tibiofemoral, patellofemoral and ankle joints, modeled using anatomically consistent kinematic models, should ease the validation of the model using joint contact forces measured with instrumented prostheses. A blinded validation based on four datasets was made under two different minimization conditions (i.e., C1 - only musculo-tendon forces are minimized, and C2 - musculo-tendon, joint contact, ligament and bone forces are minimized while focusing more specifically on tibiofemoral joint contacts). The results show that the model is able to estimate in most cases the correct timing of musculo-tendon forces during normal gait (i.e., the mean coefficient of active/inactive state concordance between estimated musculo-tendon force and measured EMG envelopes was C1: 65.87% and C2: 60.46%). The results also showed that the model is potentially able to well estimate joint contact, ligament and bone forces and more specifically medial (i.e., the mean RMSE between estimated joint contact force and in vivo measurement was C1: 1.14BW and C2: 0.39BW) and lateral (i.e., C1: 0.65BW and C2: 0.28BW) tibiofemoral contact forces during normal gait. However, the results remain highly influenced by the optimization weights that can bring to somewhat aphysiological musculo-tendon forces.

Segment-interaction in sprint start: Analysis of 3D angular velocity and kinetic energy in elite sprinters

The aim of the present study was to measure during a sprint start the joint angular velocity and the kinetic energy of the different segments in elite sprinters. This was performed using a 3D kinematic analysis of the whole body. Eight elite sprinters (10.30+/-0.14s 100 m time), equipped with 63 passive reflective markers, realised four maximal 10 m sprints start on an indoor track. An opto-electronic Motion Analysis system consisting of 12 digital cameras (250 Hz) was used to collect the 3D marker trajectories. During the pushing phase on the blocks, the 3D angular velocity vector and its norm were calculated for each joint. The kinetic energy of 16 segments of the lower and upper limbs and of the total body was calculated. The 3D kinematic analysis of the whole body demonstrated that joints such as shoulders, thoracic or hips did not reach their maximal angular velocity with a movement of flexion-extension, but with a combination of flexion-extension, abduction-adduction and internal-external rotation. The maximal kinetic energy of the total body was reached before clearing block (respectively, 537+/-59.3 J vs. 514.9+/-66.0 J; p< or =0.01). These results suggested that a better synchronization between the upper and lower limbs could increase the efficiency of pushing phase on the blocks. Besides, to understand low interindividual variances in the sprint start performance in elite athletes, a 3D complete body kinematic analysis shall be used.

Comparison of global and joint-to-joint methods for estimating the hip joint load and the muscle forces during walking.

A three-dimensional musculoskeletal model of the lower limb was developed to study the influence of biarticular muscles on the muscle force distribution and joint loads during walking. A complete walking cycle was recorded for 9 healthy subjects using the standard optoelectronic motion tracking system. Ground contact forces were also measured using a 6-axes force plate. Inverse dynamics was used to compute net joint reactions (forces and torques) in the lower limb. A static optimization method was then used to estimate muscle forces. Two different approaches were used: in the first one named global method, the biarticular muscles exerted a torque on the two joints they spanned at the same time, and in the second one called joint-by-joint method, these biarticular muscles were divided into two mono-articular muscles with geometrical (insertion, origin, via points) and physiological properties remained unchanged. The hip joint load during the gait cycle was then calculated taking into account the effect of muscle contractions. The two approaches resulted in different muscle force repartition: the biarticular muscles were favoured over any set of single-joint muscles with the same physiological function when using the global method. While the two approaches yielded only little difference in the resultant hip load, the examination of muscle power showed that biarticular muscles could produce positive work at one joint and negative work at the other, transferring energy between body segments and thus decreasing the metabolic cost of movement.

Soft tissue artifact compensation by linear 3D interpolation and approximation methods

Several compensation methods estimate bone pose from a cluster of skin-mounted makers, each influenced by soft tissue artifact (STA). In this study, linear 3D interpolation and approximation methods (affine mapping, Kriging and radial basis function (RBF)) and the conventional singular value decomposition (SVD) method were examined to determine their suitability for STA compensation. The ability of these four methods to estimate knee angles and displacements was compared using simulated gait data with and without added STA. The knee angle and the displacement estimates of all four methods were similar with root-mean-square errors (RMSEs) near 1.5 degrees and 4mm, respectively. The 3D interpolation and approximation methods were more complicated to implement than the conventional SVD method. However, these non-standard methods provided additional geometric (homothety, stretch) and time functions that model the deformation of the cluster of markers. This additional information may be useful to model and compensate the STA.

Upper limb joint dynamics during manual wheelchair propulsion

BACKGROUND Inverse dynamic methods have been widely used to estimate joint loads during manual wheelchair propulsion. However, the interpretation of 3D net joint moments and powers is not always straightforward. It has been suggested to use joint coordinate systems (expression of joint moment on anatomical axes) and the 3D angle between joint moment and angular velocity vectors (propulsion, resistance or stabilization joint configuration) for a better understanding of joint dynamics. METHODS Nine spinal cord injured subjects equipped with reflective markers propelled in a wheelchair with an instrumented wheel. Inverse dynamic results were interpreted using joint coordinate systems, 3D joint power and the 3D angle between the joint moment and joint angular velocity vectors at the three upper limb joints. The 3D angle was used to determine if the joints were predominantly driven (angle close to 0 or 180 degrees) or stabilized (angle close to 90 degrees ). FINDINGS The wrist and elbow joints are mainly in a stabilization configuration (angle close to 90 degrees ) with a combination of extension and ulnar deviation moments and an adduction moment respectively. The shoulder is in a propulsion configuration, but close to stabilization (angle hardly below 60 degrees ) with a combination of flexion and internal rotation moments. INTERPRETATION Stabilization configuration at the joints could partly explain the low mechanical efficiency of manual wheelchair propulsion and could give insight about injury risk at the wrist, elbow and shoulder joints.

3D inverse dynamics in non-orthonormal segment coordinate system

The net joint forces and moments may be computed by several 3D inverse dynamic methods. To do so, an orthonormal segment coordinate system (SCS) is generally mandatory. However, the segment axes ought to be selected following anatomical, functional, and inertial requirements that are hardly compatible with orthogonal axes. An alternative method based on generalized coordinates allows computing inverse dynamics using directly a set of basic points and unitary vectors. A segment definition is put forward in order to follow all of the anatomical, functional, and inertial requirements and the inverse dynamics is performed in a non orthonormal segment coordinate system (NSCS). The NSCS seems a convenient definition in biomechanics as far as anatomical, functional and inertial axes are concerned, but providing that the 3D joint forces and moments are still computable. The inverse dynamic method in NSCS is applied to the gait of a knee valgus subject and compared to a classical inverse dynamic method. The inverse dynamic method in NSCS shows comparable results but implies further clinical interpretations.

Dynamic input to determine hip joint moments, power and work on the prosthetic limb of transfemoral amputees: ground reaction vs knee reaction:

Background: Calculation of lower limb kinetics is limited by floor-mounted force-plates. Objectives: Comparison of hip joint moments, power and mechanical work on the prosthetic limb of a transfemoral amputee calculated by inverse dynamics using either the ground reactions (force-plates) or knee reactions (transducer). Study design: Comparative analysis. Methods: Kinematics, ground reaction and knee reaction data were collected using a motion analysis system, two force-plates, and a multi-axial transducer mounted below the socket, respectively. Results: The inverse dynamics using ground reaction underestimated the peaks of hip energy generation and absorption occurring at 63% and 76% of the gait cycle (GC) by 28% and 54%, respectively. This method also overestimated by 24% a phase of negative work at the hip (37%–56% GC), and underestimated the phases of positive (57%–72% GC) and negative (73%–98%GC) work at the hip by 11% and 58%, respectively. Conclusions: A transducer mounted within the prosthesis has the capacity to provide more realistic kinetics of the prosthetic limb because it enables assessment of multiple consecutive steps and a wide range of activities without the issue of foot placement on force-plates. Clinical relevance The hip is the only joint an amputee controls directly to set the prosthesis in motion. Hip joint kinetics are associated with joint degeneration, low back pain, risk of falls, etc. Therefore, realistic assessment of hip kinetics over multiple gait cycles and a wide range of activities is essential.

Influence of joint models on lower-limb musculo-tendon forces and three-dimensional joint reaction forces during gait:

Several three-dimensional (3D) lower-limb musculo-skeletal models have been developed for gait analysis and different hip, knee and ankle joint models have been considered in the literature. Conversely to the influence of the musculo-tendon geometry, the influence of the joint models - i.e. number of degrees of freedom and passive joint moments - on the estimated musculo-tendon forces and 3D joint reaction forces has not been extensively examined. In this paper musculo-tendon forces and 3D joint reaction forces have been estimated for one subject and one gait cycle with nine variations of a musculoskeletal model and outputs have been compared to measured electromyographic signals and knee joint contact forces. The model outputs are generally in line with the measured signals. However, the 3D joint reaction forces were higher than published values and the contact forces measured for the subject. The results of this study show that, with more degrees of freedom in the model, the musculo-tendon forces and the 3D joint reaction forces tend to increase but with some redistribution between the muscles. In addition, when taking into account passive joint moments, the 3D joint reaction forces tend to decrease during the stance phase and increase during the swing phase. Although further investigations are needed, a five-degree-of-freedom lower-limb musculo-skeletal model with some angle-dependent joint coupling and stiffness seems to provide satisfactory musculo-tendon forces and 3D joint reaction forces.