Protocol for constructing subject-specific biomechanical models of knee joint

A robust protocol for building subject-specific biomechanical models of the human knee joint is proposed which uses magnetic resonance imaging, motion analysis and force platform data in conjunction with detailed 3D finite element models. The proposed protocol can be used for determining stress and strain distributions and contact kinetics in different knee elements at different body postures during various physical activities. Several examples are provided to highlight the capabilities and potential applications of the proposed protocol. This includes preliminary results on the role of body weight on the stresses and strains induced in the knee articular cartilages and meniscus during single-leg stance and calculations of the induced stresses and ligament forces during the gait cycle.     

Surface EMG and torsion measurements during snow skiing: laboratory and field tests

The relationship between mean rectified EMG (MREMG) measured with surface electrodes and the longitudinal torsion of the lower extremity was investigated in laboratory and snow skiing experiments. Linear regression of the MREMG from the gluteus medius and the peroneus longus with the torsion measured at the foot in the laboratory tests showed that torsion can be predicted with correlation coefficients greater than 0.95 and with a standard deviation less than 5 Nm over all knee flexions and weight bearing. A similar correspondence between MREMG and torsion during skiing does not exist. MREMG is dominantly correlated to posture and body position control functions in skiing. During falling, during ski binding release, and during possible injury sustaining situations, the MREMG was always relatively large, but it was not distinguishable from that associated with smaller torsion of the lower extremity.     

In vitro analysis of varus-valgus laxity of the knee joint: Comparison of clinical evaluation with measurements using a reference motion analysis system

IntroductionNumerous measurement devices can help clinicians during the knee examination. However, manual evaluation still remains routinely used to assess the knee laxities. The present study evaluated how accurate was a clinician for a varus-valgus stress test. We compared the clinician evaluation to the objective measurement of the knee movements during the same test session.MethodsWe studied six fresh-frozen anatomical lower limbs. The clinician performed a varus-valgus stress test in extension and at 25° flexion. The limbs were equipped with intracortical pins in femur and tibia, and spherical retro-reflecting markers were glued on the pins. Objective knees movements were measured by means of a Motion Analysis^® system (Motion Analysis Corporation, Santa Rosa, CA, USA). Two statistical analyses were performed. A single sample t-test was first used to verify the required 25? flexion. Then, a multivariate anova was performed to analyse the varus-valgus laxity under the fixed factors of measurement method and flexion of the knee.ResultsThe results for varus-valgus and total laxity of the clinician always exhibited a greater variability than objective measurements of the device. Test condition is a factor of grouping differences for Valgus and for global mediolateral laxity. Statistical analysis revealed that the objective measurement was able to show a difference between extension and 25° flexion for global mediolateral laxity, whereas the clinician was not.DiscussionThe clinician was relatively accurate in his manual evaluation. However, we demonstrated that a measurement device could clearly help clinician to exhibit differences in laxity. This can be very useful to compare a knee to itself in two successive conditions, e.g., before and after a surgery.     

Human locomotion on snow: determinants of economy and speed of skiing across the ages

We explore here the evolution of skiing locomotion in the last few thousand years by investigating how humans adapted to move effectively in lands where a cover of snow, for several months every year, prevented them from travelling as on dry ground. Following historical research, we identified the sets of skis corresponding to the 'milestones' of skiing evolution in terms of ingenuity and technology, built replicas of them and measured the metabolic energy associated to their use in a climate-controlled ski tunnel.Six sets of skis were tested, covering a span from 542 AD to date. Our results show that: (i) the history of skiing is associated with a progressive decrease in the metabolic cost of transport, (ii) it is possible today to travel at twice the speed of ancient times using the same amount of metabolic power and (iii) the cost of transport is speed-independent for each ski model, as during running. By combining this finding with the relationship between time of exhaustion and the sustainable fraction of metabolic power, a prediction of the maximum skiing speed according to the distance travelled is provided for all past epochs, including two legendary historical journeys (1206 and 1520 AD) on snow. Our research shows that the performances in races originating from them (Birkebeiner and Vasaloppet) and those of other modern competitions (skating versus classical techniques) are well predicted by the evolution of skiing economy. Mechanical determinants of the measured progression in economy are also discussed in the paper.     

Automated creation and tuning of personalised muscle paths for OpenSim musculoskeletal models of the knee joint

Biomechanics and Modeling in Mechanobiology - Computational modelling is an invaluable tool for investigating features of human locomotion and motor control which cannot be measured except through...     

理论雪期和滑雪气候适宜度评价——以长白山滑雪场为例

为科学分析雪资源气候属性,定量评价滑雪运动气候适宜度概况,本研究基于天气学原理,从气候角度设定了理论雪期概念;设定与滑雪运动密切相关的气温、风速、雪期降雪量3个指标的不同适宜度等级阈值,对各指标进行归一化处理并设计其转换函数;运用灰色关联度理论,结合欧氏距离法,构建滑雪气候适宜度指数评价模型,并以长白山滑雪场为例进行评价。结果表明: 长白山地区雪资源丰富,1981—2018年,理论雪期内的平均降雪量为64.6 mm;气候变暖背景下,平均雪期日数及降雪量随年代呈略有减少趋势,雪期开始时间随年代变化呈现延后趋势,结束时间呈提前趋势,且前冬(当年雪期开始至12月底)雪期日数明显少于后冬(次年1月初至雪期结束)雪期日数;长白山滑雪场雪期内滑雪气候适宜性高,气温、风速和降雪条件的最适宜和较适宜日数累计分别占91.9%、91.8%和94.6%;滑雪综合气候适宜度日数累计占比达99.7%,绝大多数时间适宜滑雪运动的开展。理论雪期概念的提出弥补了因初、终雪气象观测资料缺乏对雪资源研究等造成的困扰;滑雪运动气候适宜度评价模型可为滑雪场地开发和经营提供管理决策,为滑雪爱好者提供出行的科学支撑。     

Simultaneous control of hand displacements and rotations in orientation-matching experiments.

In reach-to-grasp movements, the interaction between the hand changes in position and those in orientation is poorly understood. A theoretical approach previously proposed (Torres EB and Zipser D. J Neurophysiol 88: 1-13, 2002) assumes that motion strategies are resolved in space independently from the temporal dynamics of the motion and predicts the coarticulation of the hand transport and rotation along the path. The model implies that this simultaneous control is independent of variations in speed and initial posture and required matching orientation. This paper presents experimental data from human subjects that confirm the model's predictions in the context of realistic, unconstrained, orientation-matching motions. Speed independence is quantified in the similarity of the postural and endpoint position-orientation paths obtained under three different speeds. Significant differences in hand and joint kinematics are shown in response to changes in initial posture and target orientation. The robustness of coarticulation under all three experimental conditions supports the idea of an intermediate stage that resolves the geometry of the motion independent of its temporal dynamics.     

Measurement of strength and loading variables on the knee during Alpine skiing

The study focusses on the prevention of knee injuries during snow skiing. In order to develop a technology of knee injury prevention, both the strength and loading on the knee during skiing activity must be known. This paper reports measurements of variables influencing both knee strength and loading of the joint. The strength variables measured included the degree of activity in six muscles crossing the knee, the knee flexion angle, and the axial load (i.e. weight bearing) transmitted to the knee. Transducers included surface electrodes to monitor electromyogram signals indicating the degree of muscle activity and a goniometer to measure both hip and knee flexion angles. The complete loading on the knee was derived from a dynamometer which measured the six load components at the boot-dynamometer interface. The transducer data were acquired and stored by a compact, battery powered digital data acquisition-controller system. Three male subjects of similar physical size (nominal was 1.8 m and 75 kg) and skiing ability (advanced intermediate to expert) were tested under similar conditions. Each subject skied a total of four slalom runs--one snowplow and three parallel. The total time of each test was 21 s. Example data plots from different types of runs are presented and discussed. Based on observations from the data, necessary performance features for ski bindings offering improved protection from knee ligamentous injuries are defined.     

Comparative assessment of knee joint models used in multi-body kinematics optimisation for soft tissue artefact compensation

Estimating joint kinematics from skin-marker trajectories recorded using stereophotogrammetry is complicated by soft tissue artefact (STA), an inexorable source of error. One solution is to use a bone pose estimator based on multi-body kinematics optimisation (MKO) embedding joint constraints to compensate for STA. However, there is some debate over the effectiveness of this method. The present study aimed to quantitatively assess the degree of agreement between reference (i.e., artefact-free) knee joint kinematics and the same kinematics estimated using MKO embedding six different knee joint models. The following motor tasks were assessed: level walking, hopping, cutting, running, sit-to-stand, and step-up. Reference knee kinematics was taken from pin-marker or biplane fluoroscopic data acquired concurrently with skin-marker data, made available by the respective authors. For each motor task, Bland-Altman analysis revealed that the performance of MKO varied according to the joint model used, with a wide discrepancy in results across degrees of freedom (DoFs), models and motor tasks (with a bias between −10.2° and 13.2° and between −10.2 mm and 7.2 mm, and with a confidence interval up to ±14.8° and ±11.1 mm, for rotation and displacement, respectively). It can be concluded that, while MKO might occasionally improve kinematics estimation, as implemented to date it does not represent a reliable solution to the STA issue.     

Memory for events and their spatial context: models and experiments

The computational role of the hippocampus in memory has been characterized as: (i) an index to disparate neocortical storage sites; (ii) a time-limited store supporting neocortical long-term memory; and (iii) a content-addressable associative memory. These ideas are reviewed and related to several general aspects of episodic memory, including the differences between episodic, recognition and semantic memory, and whether hippocampal lesions differentially affect recent or remote memories. Some outstanding questions remain, such as: what characterizes episodic retrieval as opposed to other forms of read-out from memory; what triggers the storage of an event memory; and what are the neural mechanisms involved? To address these questions a neural-level model of the medial temporal and parietal roles in retrieval of the spatial context of an event is presented. This model combines the idea that retrieval of the rich context of real-life events is a central characteristic of episodic memory, and the idea that medial temporal allocentric representations are used in long-term storage while parietal egocentric representations are used to imagine, manipulate and re-experience the products of retrieval. The model is consistent with the known neural representation of spatial information in the brain, and provides an explanation for the involvement of Papez''s circuit in both the representation of heading direction and in the recollection of episodic information. Two experiments relating to the model are briefly described. A functional neuroimaging study of memory for the spatial context of life-like events in virtual reality provides support for the model''s functional localization. A neuropsychological experiment suggests that the hippocampus does store an allocentric representation of spatial locations.     

Uncertainty of knee joint muscle activity during knee joint torque exertion: the significance of controlling adjacent joint torque.

In the single-joint torque exertion task, which has been widely used to control muscle activity, only the relevant joint torque is specified. However, the neglect of the neighboring joint could make the procedure unreliable, considering our previous result that even monoarticular muscle activity level is indefinite without specifying the adjacent joint torque. Here we examined the amount of hip joint torque generated with knee joint torque and its influence on the activity of the knee joint muscles. Twelve healthy subjects were requested to exert various levels of isometric knee joint torque. The knee and hip joint torques were obtained by using a custom-made device. Because no information about hip joint torque was provided to the subjects, the hip joint torque measured here was a secondary one associated with the task. The amount of hip joint torque varied among subjects, indicating that they adopted various strategies to achieve the task. In some subjects, there was a considerable internal variability in the hip joint torque. Such variability was not negligible, because the knee joint muscle activity level with respect to the knee joint torque, as quantified by surface electromyography (EMG), changed significantly when the subjects were requested to change the strategy. This change occurred in a very systematic manner: in the case of the knee extension, as the hip flexion torque was larger, the activity of mono- and biarticular knee extensors decreased and increased, respectively. These results indicate that the conventional single knee joint torque exertion has the drawback that the intersubject and/or intertrial variability is inevitable in the relative contribution among mono- and biarticular muscles because of the uncertainty of the hip joint torque. We discuss that the viewpoint that both joint torques need to be considered will bring insights into various controversial problems such as the shape of the EMG-force relationship, neural factors that help determine the effect of muscle strength training, and so on.     

Morphomechanics: goals, basic experiments and models

Morphomechanics is a branch of developmental biology, studying the generation, space-time patterns and morphogenetic role of mechanical stresses (MS) which reside in embryonic tissues. All the morphogenetically active embryonic tissues studied in this respect have been shown to bear substantial mechanical stresses of tension or pressure. MS are indispensable for organized cell movements, expression of a number of developmentally important genes and the very viability of cells. Even a temporary relaxation of MS leads to an increase in the morphological variability and asymmetry of embryonic rudiments. Moreover, MS may be among the decisive links of morphogenetic feedback required for driving forth embryonic development and providing its regular space-time patterns. We hypothesize that one such feedback is based upon the tendency of cells and tissues to hyperrestore (restore with an overshoot) their MS values after any deviations, either artificial or produced by neighboring morphogenetically active tissues. This idea is supported by a number of observations and experiments performed on the tissue and individual cell levels. We describe also the models demonstrating that a number of biologically realistic stationary shapes and propagating waves can be generated by varying the parameters of the hyperrestoration feedback loop. Morphomechanics is an important and rapidly developing branch of developmental and cell biology, being complementary to other approaches.     

Multi-level personalization of neuromusculoskeletal models to estimate physiologically plausible knee joint contact forces in children

Neuromusculoskeletal models are a powerful tool to investigate the internal biomechanics of an individual. However, commonly used neuromusculoskeletal models are generated via linear scaling of generic templates derived from elderly adult anatomies and poorly represent a child, let alone children with a neuromuscular disorder whose musculoskeletal structures and muscle activation patterns are profoundly altered. Model personalization can capture abnormalities and appropriately describe the underlying (altered) biomechanics of an individual. In this work, we explored the effect of six different levels of neuromusculoskeletal model personalization on estimates of muscle forces and knee joint contact forces to tease out the importance of model personalization for normal and abnormal musculoskeletal structures and muscle activation patterns. For six children, with and without cerebral palsy, generic scaled models were developed and progressively personalized by (1) tuning and calibrating musculotendon units’ parameters, (2) implementing an electromyogram-assisted approach to synthesize muscle activations, and (3) replacing generic anatomies with image-based bony geometries, and physiologically and physically plausible muscle kinematics. Biomechanical simulations of gait were performed in the OpenSim and CEINMS software on ten overground walking trials per participant. A mixed-ANOVA test, with Bonferroni corrections, was conducted to compare all models’ estimates. The model with the highest level of personalization produced the most physiologically plausible estimates. Model personalization is crucial to produce physiologically plausible estimates of internal biomechanical quantities. In particular, personalization of musculoskeletal anatomy and muscle activation patterns had the largest effect overall. Increased research efforts are needed to ease the creation of personalized neuromusculoskeletal models.

     

Effect of knee joint flexion and femur rotation on retropatellar contact of the human knee joint]

The aim of the present study was to evaluate retropatellar contact characteristics at different angles of flexion of the knee joint. To this end, 6 cadaveric legs were examined using pressure sensitive film (Fuji Prescale type "super low") at angles of flexion of 45 degrees, 60 degrees, 90 degrees and 120 degrees both in neutral rotation and 10 degrees internal and external rotation of the femur in the same knee joints. A force of 140 N was applied to both the vastus medialis and lateralis, and a comparison made with a medially and a laterally dominating muscle force. The contact areas decreased with increasing angles of flexion. The medially dominating muscle traction increased the contact area. Comparison between internal and external rotation revealed a decrease in contact area on internal rotation. The pressure measurements were comparable in all loading situations. Comparison between neutral and medial traction revealed significant differences in contact area, pressure and force. The influence of femoral rotation showed no significant difference. A comparison of the different angles of flexion revealed only few significant differences. To prevent the development of retropatellar arthrosis, maximum contact areas are necessary. The study has shown an advantage for medially dominating muscle traction, and external rotation of the femur.