Lower-extremity musculoskeletal geometry affects the calculation of patellofemoral forces in vertical jumping and weightlifting

The calculation of the patellofemoral joint contact force using three-dimensional (3D) modelling techniques requires a description of the musculoskeletal geometry of the lower limb. In this study, the influence of the complexity of the muscle model was studied by considering two different muscle models, the Delp and Horsman models. Both models were used to calculate the patellofemoral force during standing, vertical jumping, and Olympic-style weightlifting. The patellofemoral forces predicted by the Horsman model were markedly lower than those predicted by the Delp model in all activities and represented more realistic values when compared with previous work. This was found to be a result of a lower level of redundancy in the Delp model, which forced a higher level of muscular activation in order to allow a viable solution. The higher level of complexity in the Horsman model resulted in a greater degree of redundancy and consequently lower activation and patellofemoral forces. The results of this work demonstrate that a well-posed muscle model must have an adequate degree of complexity to create a sufficient independence, variability, and number of moment arms in order to ensure adequate redundancy of the force-sharing problem such that muscle forces are not overstated. (Author's abstract

The development of a segment-based musculoskeletal model of the lower limb: Introducing FreeBody

Traditional approaches to the biomechanical analysis of movement are joint-based; that is the mechanics of the body are described in terms of the forces and moments acting at the joints, and that muscular forces are considered to create moments about the joints. We have recently shown that segment-based approaches, where the mechanics of the body are described by considering the effect of the muscle, ligament and joint contact forces on the segments themselves, can also prove insightful. We have also previously described a simultaneous, optimization-based, musculoskeletal model of the lower limb. However, this prior model incorporates both joint- and segment-based assumptions. The purpose of this study was therefore to develop an entirely segment-based model of the lower limb and to compare its performance to our previous work. The segment-based model was used to estimate the muscle forces found during vertical jumping, which were in turn compared with the muscular activations that have been found in vertical jumping, by using a Geers’ metric to quantify the magnitude and phase errors. The segment-based model was shown to have a similar ability to estimate muscle forces as a model based upon our previous work. In the future, we will evaluate the ability of the segment-based model to be used to provide results with clinical relevance, and compare its performance to joint-based approaches. The segment-based model described in this article is publicly available as a GUIbasedMATLAB _ application and in the original source code (at www.msksoftware.org.uk)

An Optimization-Based Simultaneous Approach to the Determination of Muscular, Ligamentous, and Joint Contact Forces Provides Insight into Musculoligamentous Interaction

Typical inverse dynamics approaches to the calculation of muscle, ligament, and joint contact forces are based on a step-wise solution of the equations of motion. This approach is therefore limited in its ability to provide insight as to the muscular, ligamentous, and articular interactions that create joint stability. In this study, a new musculoskeletal model of the lower limb is described, in which the equations of motion describing the force and moment equilibrium at the joints of the lower limb are solved simultaneously using optimization techniques. The new model was employed to analyze vertical jumping using a variety of different optimization cost functions and the results were compared to more traditional approaches. The new model was able to find a solution with lower muscular force upper bounds due to the ability of the ligaments to contribute to moment equilibrium at the ankle and knee joints. Equally, the new model produced lower joint contact forces than traditional approaches for cases which also included a consideration as to ligament or joint contact forces within the cost function. This study demonstrates the possibility of solving the inverse dynamic equations of motion simultaneously using contemporary technology, and further suggests that this might be important due to the complementary function of the muscles and ligaments in creating joint stability

Influence of inverse dynamics methods on the calculation of inter-segmental moments in vertical jumping and weightlifting

<p>Abstract</p> <p>Background</p> <p>A vast number of biomechanical studies have employed inverse dynamics methods to calculate inter-segmental moments during movement. Although all inverse dynamics methods are rooted in classical mechanics and thus theoretically the same, there exist a number of distinct computational methods. Recent research has demonstrated a key influence of the dynamics computation of the inverse dynamics method on the calculated moments, despite the theoretical equivalence of the methods. The purpose of this study was therefore to explore the influence of the choice of inverse dynamics on the calculation of inter-segmental moments.</p> <p>Methods</p> <p>An inverse dynamics analysis was performed to analyse vertical jumping and weightlifting movements using two distinct methods. The first method was the traditional inverse dynamics approach, in this study characterized as the 3 step method, where inter-segmental moments were calculated in the local coordinate system of each segment, thus requiring multiple coordinate system transformations. The second method (the 1 step method) was the recently proposed approach based on wrench notation that allows all calculations to be performed in the global coordinate system. In order to best compare the effect of the inverse dynamics computation a number of the key assumptions and methods were harmonized, in particular unit quaternions were used to parameterize rotation in both methods in order to standardize the kinematics.</p> <p>Results</p> <p>Mean peak inter-segmental moments calculated by the two methods were found to agree to 2 decimal places in all cases and were not significantly different (p > 0.05). Equally the normalized dispersions of the two methods were small.</p> <p>Conclusions</p> <p>In contrast to previously documented research the difference between the two methods was found to be negligible. This study demonstrates that the 1 and 3 step method are computationally equivalent and can thus be used interchangeably in musculoskeletal modelling technology. It is important that future work clarifies the influence of the other inverse dynamics methods on the calculation of inter-segmental moments. Equally future work is needed to explore the sensitivity of kinematics computations to the choice of rotation parameterization.</p

Hip and knee joint loading during vertical jumping and push jerking

BACKGROUND: The internal joint contact forces experienced at the lower limb have been frequently studied in activities of daily living and rehabilitation activities. In contrast, the forces experienced during more dynamic activities are not well understood, and those studies that do exist suggest very high degrees of joint loading. METHODS: In this study a biomechanical model of the right lower limb was used to calculate the internal joint forces experienced by the lower limb during vertical jumping, landing and push jerking (an explosive exercise derived from the sport of Olympic weightlifting), with a particular emphasis on the forces experienced by the knee. FINDINGS: The knee experienced mean peak loadings of 2.4-4.6×body weight at the patellofemoral joint, 6.9-9.0×body weight at the tibiofemoral joint, 0.3-1.4×body weight anterior tibial shear and 1.0-3.1×body weight posterior tibial shear. The hip experienced a mean peak loading of 5.5-8.4×body weight and the ankle 8.9-10.0×body weight. INTERPRETATION: The magnitudes of the total (resultant) joint contact forces at the patellofemoral joint, tibiofemoral joint and hip are greater than those reported in activities of daily living and less dynamic rehabilitation exercises. The information in this study is of importance for medical professionals, coaches and biomedical researchers in improving the understanding of acute and chronic injuries, understanding the performance of prosthetic implants and materials, evaluating the appropriateness of jumping and weightlifting for patient populations and informing the training programmes of healthy populations. Copyright © 2012 Elsevier Ltd. All rights reserved

Rapid-sequence MRI for long-term surveillance for paraganglioma and phaeochromocytoma in patients with succinate dehydrogenase (SDHx) mutations

INTRODUCTION: Patients with SDHx mutations need long-term radiological surveillance for the development of paragangliomas and phaeochromocytomas, but no longitudinal data exist. We assessed the performance of rapid-sequence non-contrast magnetic resonance imaging (MRI) in the long-term monitoring of patients with SDHx mutations. METHODS: Retrospective study between 2005-2015 at a University Hospital and regional endocrine genetics referral center. Clinical and imaging data of forty-seven patients with SDHx mutations [SDHB (36), SDHC (6), SDHD (5)] who had surveillance for detection of paragangliomas by rapid-sequence non-contrast MRI (base of skull to pubic symphysis) were collected. RESULTS: Twelve index cases (9 SDHB, 1 SDHC, 2 SDHD) and 35 mutation-positive relatives were monitored for a mean of 6.4 years (range 3.1 to 10.0 years). Mean age at the end of the study: SDHB 46.9+/-17.6 years; SDHC 42.3+/-24.4 years; SDHD 54.9 +/- 10.6 years. Excluding imaging at initial diagnosis of index cases forty-three patients underwent 116 rapid-sequence MRI scans: 83 scans were negative and 31 scans were positive for a sPGL/HNPGL in 13 patients. Most patients had multiple scans [n=number of patients (number of rapid-sequence MRI scans during screening)]; n=9 (2), n=20 (3), n=6 (4), n=1 (6). Nine patients (3 index) were diagnosed with new paragangliomas during surveillance and non-operated tumour size was monitored in 9 patients. There were two false positive scans (1.6%). Scans were repeated every 27 +/- 9 months. CONCLUSIONS: Biannual rapid-sequence non-contrast MRI is effective to monitor patients with SDHx mutations for detection of new tumours and monitoring of known tumours

In vivo knee contact force prediction using patient-specific musculoskeletal geometry in a segment-based computational model

Segment-based musculoskeletal models allow the prediction of muscle, ligament, and joint forces without making assumptions regarding joint degrees-of-freedom (DOF). The dataset published for the “Grand Challenge Competition to Predict in vivo Knee Loads” provides directly measured tibiofemoral contact forces for activities of daily living (ADL). For the Sixth Grand Challenge Competition to Predict in vivo Knee Loads, blinded results for “smooth” and “bouncy” gait trials were predicted using a customized patient-specific musculoskeletal model. For an unblinded comparison, the following modifications were made to improve the predictions: further customizations, including modifications to the knee center of rotation; reductions to the maximum allowable muscle forces to represent known loss of strength in knee arthroplasty patients; and a kinematic constraint to the hip joint to address the sensitivity of the segment-based approach to motion tracking artifact. For validation, the improved model was applied to normal gait, squat, and sit-to-stand for three subjects. Comparisons of the predictions with measured contact forces showed that segment-based musculoskeletal models using patient-specific input data can estimate tibiofemoral contact forces with root mean square errors (RMSEs) of 0.48–0.65 times body weight (BW) for normal gait trials. Comparisons between measured and predicted tibiofemoral contact forces yielded an average coefficient of determination of 0.81 and RMSEs of 0.46–1.01 times BW for squatting and 0.70–0.99 times BW for sit-to-stand tasks. This is comparable to the best validations in the literature using alternative models.</jats:p

Effects of an 8-week strength training intervention on tibiofemoral joint loading during landing: a cohort study

Objectives To use a musculoskeletal model of the lower limb to evaluate the effect of a strength training intervention on the muscle and joint contact forces experienced by untrained women during landing. Methods Sixteen untrained women between 18 and 28 years participated in this cohort study, split equally between intervention and control groups. The intervention group trained for 8 weeks targeting improvements in posterior leg strength. The mechanics of bilateral and unilateral drop landings from a 30 cm platform were recorded preintervention and postintervention, as was the isometric strength of the lower limb during a hip extension test. The internal muscle and joint contact forces were calculated using FreeBody, a musculoskeletal model. Results The strength of the intervention group increased by an average of 35% (P<0.05; pre: 133±36 n, post: 180±39 n), whereas the control group showed no change (pre: 152±36 n, post: 157±46 n). There were only small changes from pre-test to post-test in the kinematics and ground reaction forces during landing that were not statistically significant. Both groups exhibited a post-test increase in gluteal muscle force during landing and a lateral to medial shift in tibiofemoral joint loading in both landings. However, the magnitude of the increase in gluteal force and lateral to medial shift was significantly greater in the intervention group. Conclusion Strength training can promote a lateral to medial shift in tibiofemoral force (mediated by an increase in gluteal force) that is consistent with a reduction in valgus loading. This in turn could help prevent injuries that are due to abnormal knee loading such as anterior cruciate ligament ruptures,patellar dislocation and patellofemoral pain

Modelling of stress transfer in root-reinforced soils informed by four-dimensional X-ray computed tomography and digital volume correlation data

Vegetation enhances soil shearing resistance through water uptake and root reinforcement. Analytical models for soils reinforced with roots rely on input parameters that are difficult to measure, leading to widely varying predictions of behaviour. The opaque heterogeneous nature of rooted soils results in complex soil-root interaction mechanisms that cannot easily be quantified. The authors measured, for the first time, the shear resistance and deformations of fallow, willow-rooted, and gorse-rooted soils during direct shear using X-ray computed tomography and digital volume correlation. Both species caused an increase in shear zone thickness, both initially and as shear progressed. Shear zone thickness peaked at up to 35 mm, often close to the thickest roots and towards the centre of the column. Root extension during shear was 10-30% less than the tri-linear root profile assumed in a Waldron-type model, owing to root curvature. Root analogues used to explore the root-soil interface behaviour suggested that root lateral branches play an important role in anchoring the roots. The Waldron-type model was modified to incorporate non-uniform shear zone thickness and growth, and accurately predicted the observed, up to seven-fold, increase in shear resistance of root-reinforced soil