Lode Bosmans

Hip contact force in presence of aberrant bone geometry during normal and pathological gait

Children with cerebral palsy (CP) often present aberrant hip geometry, specifically increased femoral anteversion and neck‐shaft angle. Furthermore, altered gait patterns are present within this population. We analyzed the effect of aberrant femoral geometry, as present in CP subjects, on hip contact force (HCF) during pathological and normal gait. We ran dynamic simulations of CP‐specific and normal gait using two musculoskeletal models (MSMs), one reflecting normal femoral geometry and one reflecting proximal femoral deformities. The combination of aberrant bone geometry and CP‐specific gait characteristics reduced HCF compared to normal gait on a CP subject‐specific MSM, but drastically changed the orientation of the HCF vector. The HCF was orientated more vertically and anteriorly than compared to HCF orientation during normal gait. Furthermore, subjects with more pronounced bony deformities encountered larger differences in resultant HCF and HCF orientation. When bone deformities were not accounted for in MSMs of pathologic gait, the HCF orientation was more similar to normal children. Thus, our results support a relation between aberrant femoral geometry and joint loading during pathological/normal gait and confirm a compensatory effect of altered gait kinematics on joint loading.

Sensitivity of predicted muscle forces during gait to anatomical variability in musculotendon geometry.

Scaled generic musculoskeletal models are commonly used to drive dynamic simulations of motions. It is however, acknowledged that not accounting for variability in musculoskeletal geometry and musculotendon parameters may confound the simulation results, even when analysing control subjects. This study documents the three-dimensional anatomical variability of musculotendon origins and insertions of 33 lower limb muscles determined based on magnetic resonance imaging in six subjects. This anatomical variability was compared to the musculotendon point location in a generic musculoskeletal model. Furthermore, the sensitivity of muscle forces during gait, calculated using static optimization, to perturbations of the musculotendon point location was analyzed with a generic model. More specific, a probabilistic approach was used: for each analyzed musculotendon point, the three-dimensional location was re-sampled with a uniform Latin hypercube method within the anatomical variability and the static optimization problem was then re-solved for all perturbations. We found that musculotendon point locations in the generic model showed only variable correspondences with the anatomical variability. The anatomical variability of musculotendon point location did affect the calculated muscle forces: muscles most sensitive to perturbations within the anatomical variability are iliacus and psoas. Perturbation of the gluteus medius anterior, iliacus and psoas induces the largest concomitant changes in muscle forces of the unperturbed muscles. Therefore, when creating subject-specific musculoskeletal models, these attachment points should be defined accurately. In addition, the size of the anatomical variability of the musculotendon point location was not related to the sensitivity of the calculated muscle forces.

Quantifying individual muscle contribution to three-dimensional reaching tasks

We investigated the individual muscle contribution to arm motion to better understand the complex muscular coordination underlying three-dimensional (3D) reaching tasks of the upper limb (UL). The individual contributions of biceps, triceps, deltoid anterior, medius, posterior and pectoralis major to the control of specific degrees of freedom (DOFs) were examined: using a scaled musculoskeletal model, the muscle excitations that reproduce the kinematics were calculated using computed muscle control and a forward simulation was generated. During consequent perturbation analyses, the muscle excitation of selected muscles was instantaneously increased and the resulting effect on the specific DOF was studied to quantify the muscle contribution. The calculated muscle contributions were compared to the responses elicited during electrical stimulation experiments. Innovative in our findings is that muscle action during reaching clearly depended on the reaching trajectory in 3D space. For the majority of the muscles, the magnitude of muscle action changed and even reversed when reaching to different heights and widths. Furthermore, muscle effects on non spanned joints were reported. Using a musculoskeletal model and forward simulation techniques, we demonstrate individual position-dependent muscle contributions to 3D joint kinematics of the UL.

Functional knee axis based on isokinetic dynamometry data: comparison of two methods, MRI validation, and effect on knee joint kinematics

This paper compares geometry-based knee axes of rotation (transepicondylar axis and geometric center axis) and motion-based functional knee axes of rotation (fAoR). Two algorithms are evaluated to calculate fAoRs: Gamage and Lasenbys sphere fitting algorithm (GL) and Ehrig et al.s axis transformation algorithm (SARA). Calculations are based on 3D motion data acquired during isokinetic dynamometry. AoRs are validated with the equivalent axis based on static MR-images. We quantified the difference in orientation between two knee axes of rotation as the angle between the projection of the axes in the transversal and frontal planes, and the difference in location as the distance between the intersection points of the axes with the sagittal plane. Maximum differences between fAoRs resulting from GL and SARA were 5.7° and 15.4mm, respectively. Maximum differences between fAoRs resulting from GL or SARA and the equivalent axis were 5.4°/11.5mm and 8.6°/12.8mm, respectively. Differences between geometry-based axes and EA are larger than differences between fAoR and EA both in orientation (maximum 10.6°).and location (maximum 20.8mm). Knee joint angle trajectories and the corresponding accelerations for the different knee axes of rotation were estimated using Kalman smoothing. For the joint angles, the maximum RMS difference with the MRI-based equivalent axis, which was used as a reference, was 3°. For the knee joint accelerations, the maximum RMS difference with the equivalent axis was 20°/s(2). Functional knee axes of rotation describe knee motion better than geometry-based axes. GL performs better than SARA for calculations based on experimental dynamometry.

Subject-specific geometrical detail rather than cost function formulation affects hip loading calculation*

Abstract This study assessed the relative importance of introducing an increasing level of medical image-based subject-specific detail in bone and muscle geometry in the musculoskeletal model, on calculated hip contact forces during gait. These forces were compared to introducing minimization of hip contact forces in the optimization criterion. With an increasing level of subject-specific detail, specifically MRI-based geometry and wrapping surfaces representing the hip capsule, hip contact forces decreased and were more comparable to contact forces measured using instrumented prostheses (average difference of 0.69 BW at the first peak compared to 1.04 BW for the generic model). Inclusion of subject-specific wrapping surfaces in the model had a greater effect than altering the cost function definition.