Subject-specific hip geometry and hip joint centre location affects calculated contact forces at the hip during gait

Hip loading affects the development of hip osteoarthritis, bone remodelling and osseointegration of implants. In this study, we analyzed the effect of subject-specific modelling of hip geometry and hip joint centre (HJC) location on the quantification of hip joint moments, muscle moments and hip contact forces during gait, using musculoskeletal modelling, inverse dynamic analysis and static optimization. For 10 subjects, hip joint moments, muscle moments and hip loading in terms of magnitude and orientation were quantified using three different model types, each including a different amount of subject-specific detail: (1) a generic scaled musculoskeletal model, (2) a generic scaled musculoskeletal model with subject-specific hip geometry (femoral anteversion, neck-length and neck-shaft angle) and (3) a generic scaled musculoskeletal model with subject-specific hip geometry including HJC location. Subject-specific geometry and HJC location were derived from CT. Significant differences were found between the three model types in HJC location, hip flexion–extension moment and inclination angle of the total contact force in the frontal plane. No model agreement was found between the three model types for the calculation of contact forces in terms of magnitude and orientations, and muscle moments. Therefore, we suggest that personalized models with individualized hip joint geometry and HJC location should be used for the quantification of hip loading. For biomechanical analyses aiming to understand modified hip joint loading, and planning hip surgery in patients with osteoarthritis, the amount of subject-specific detail, related to bone geometry and joint centre location in the musculoskeletal models used, needs to be considered.     

Biomechanical analysis of the relation between movement time and joint moment development during a sit-to-stand task

Background  

Slowness of movement is a factor that may cause a decrease of quality of daily life. Mobility in the elderly and people with movement impairments may be improved by increasing the quickness of fundamental locomotor tasks. Because it has not been revealed how much muscle strength is required to improve quickness, the purpose of this study was to reveal the relation between movement time and the required muscle strength in a sit to stand (STS) task. Previous research found that the sum of the peak hip and knee joint moments was relatively invariant throughout a range of movement patterns (Yoshioka et al., 2007, Biomedical Engineering Online 6:26). The sum of the peak hip and knee joint moment is an appropriate index to evaluate the muscle strength required for an STS task, since the effect of the movement pattern variation can be reduced, that is, the results can be evaluated purely from the viewpoint of the movement times. Therefore, the sum of the peak hip and knee joint moment was used as the index to indicate the required muscle strength.     

Effect of hip joint angle on concentric knee extension torque

This study tested the hypothesis that the effect of hip joint angle on concentric knee extension torque depends on knee joint angle during a single knee extension task. Twelve men performed concentric knee extensions in fully extended and 80° flexed hip positions with maximal effort. The angular velocities were set at 30° s⁻¹ and 180° s⁻¹. The peak torque and torques attained at 30°, 50°, 70° and 90° (anatomical position = 0°) of the knee joint were compared between the two hip positions. Muscle activations of the vastus lateralis, medialis, rectus femoris and biceps femoris were determined using surface electromyography. The peak torque was significantly greater in the flexed than in the extended hip position irrespective of angular velocity. The torques at 70° and 90° of the knee joint at both angular velocities and at 50° at 180° s⁻¹ were significantly greater in the flexed than in the extended hip position, whereas corresponding differences were not found at 30° (at either angular velocity) and 50° (at 30° s⁻¹) of the knee joint. No effect of hip position on muscle activation was observed in any muscle. These results supported our hypothesis and may be related to the force–length and force–velocity characteristics of the rectus femoris.     

Contributions of individual muscles to hip joint contact force in normal walking

The human hip joint withstands high contact forces during daily activity and is therefore susceptible to injury and structural deterioration over time. Knowledge of muscle-force contributions to hip joint loading may assist in the development of strategies to prevent and manage conditions such as osteoarthritis, femoro-acetabular impingement and fracture. The main aim of this study was to determine the contributions of individual muscles to hip contact force in normal walking. Muscle contributions to hip contact force were calculated based on a previously published dynamic optimization solution for normal walking, which provided the time histories of joint motion, ground reaction forces, and muscle forces during the stance and swing phases of gait. The force developed by each muscle plus its contribution to the ground reaction force were used to determine the muscle’s contribution to hip contact force. Muscles were the major contributors to hip contact force, with gravitational and centrifugal forces combined contributing less than 5% of the total contact force. Four muscles that span the hip – gluteus medius, gluteus maximus, iliopsoas, and hamstrings – contributed most significantly to the three components of the hip contact force and hip contact impulse (integral of hip contact force over time). Three muscles that do not span the hip – vasti, soleus, and gastrocnemius – also contributed substantially to hip joint loading. These results provide additional insight into lower-limb muscle function during walking and may also be relevant to studies of cartilage degeneration and bone remodelling at the hip.     

Knee joint reaction force during tibial diaphyseal lengthening: a study on a rabbit model

The in vivo passive knee joint reaction force was measured in a rabbit model of tibial diaphyseal lengthening. This was based on the assumption that limb lengthening creates soft tissue tension that compresses the joint surface and generates the joint contact force. A measurement method was developed that involved the distraction of the joint and the determination of the distraction force that just separates the joint surfaces. Sixteen immature (mean+/-SD age=9+/-0.6 weeks) New Zealand White rabbits underwent 30% (left) tibial diaphyseal lengthening at a rate of two 0.4mm incremental lengthenings per day. The knee joint reaction force was measured at the end of lengthening (8 rabbits, mean+/-SD age=14+/-0.6 weeks) and five weeks after lengthening (8 rabbits, mean+/-SD age=19+/-0.7 weeks). An instrumented bilateral distractor and an extensometer were fixed cross the knee joint. The joint distraction force and distraction displacement were measured when the joint was distracted in steps and after the section of the Achilles tendon. The joint reaction force on the lengthened side was significantly higher than the control side at both time points (mean+/-SD 44.4+/-7.8 N v. 27.2+/-4.0 N at the end of lengthening, 44.3+/-S6.5 N v. 31.3+/-3.0 N at 5 weeks after lengthening). The contribution of the gastrocnemius to the joint reaction force on the lengthened side was also significantly higher than the control side at both time points (mean+/-SD 9.0+/-1.3N v. 2.8+/-0.8 N at the end of lengthening, 5.3+/-1.4N v. 2.7+/-0.5N at 5 weeks after lengthening). There were significant knee and ankle joint contractures at the end of lengthening, as evidenced by decreased range of motion (mean+/-SD 27+/-8 degrees and 36+/-13 degrees, respectively), which remained 5 weeks after lengthening (mean+/-SD 26+/-6 degrees and 35+/-8 degrees, respectively). The gastrocnemius contributed about 20% of the joint reaction force, indicating that changes in the other intra- and extra-articular structures due to joint contracture may be more important in generating the joint reaction force.     

Influence of weak hip abductor muscles on joint contact forces during normal walking: probabilistic modeling analysis

The weakness of hip abductor muscles is related to lower-limb joint osteoarthritis, and joint overloading may increase the risk for disease progression. The relationship between muscle strength, structural joint deterioration and joint loading makes the latter an important parameter in the study of onset and follow-up of the disease. Since the relationship between hip abductor weakness and joint loading still remains an open question, the purpose of this study was to adopt a probabilistic modeling approach to give insights into how the weakness of hip abductor muscles, in the extent to which normal gait could be unaltered, affects ipsilateral joint contact forces. A generic musculoskeletal model was scaled to each healthy subject included in the study, and the maximum force-generating capacity of each hip abductor muscle in the model was perturbed to evaluate how all physiologically possible configurations of hip abductor weakness affected the joint contact forces during walking. In general, the muscular system was able to compensate for abductor weakness. The reduced force-generating capacity of the abductor muscles affected joint contact forces to a mild extent, with 50th percentile mean differences up to 0.5 BW (maximum 1.7 BW). There were greater increases in the peak knee joint loads than in loads at the hip or ankle. Gluteus medius, particularly the anterior compartment, was the abductor muscle with the most influence on hip and knee loads. Further studies should assess if these increases in joint loading may affect initiation and progression of osteoarthritis.     

Motion control of the ankle joint with a multiple contact nerve cuff electrode: a simulation study

The flat interface nerve electrode (FINE) has demonstrated significant capability for fascicular and subfascicular stimulation selectivity. However, due to the inherent complexity of the neuromuscular skeletal systems and nerve–electrode interface, a trajectory tracking motion control algorithm of musculoskeletal systems for functional electrical stimulation using a multiple contact nerve cuff electrode such as FINE has not yet been developed. In our previous study, a control system was developed for multiple-input multiple-output (MIMO) musculoskeletal systems with little prior knowledge of the system. In this study, more realistic computational ankle/subtalar joint model including a finite element model of the sciatic nerve was developed. The control system was tested to control the motion of ankle/subtalar joint angles by modulating the pulse amplitude of each contact of a FINE placed on the sciatic nerve. The simulation results showed that the control strategy based on the separation of steady state and dynamic properties of the system resulted in small output tracking errors for different reference trajectories such as sinusoidal and filtered random signals. The proposed control method also demonstrated robustness against external disturbances and system parameter variations such as muscle fatigue. These simulation results under various circumstances indicate that it is possible to take advantage of multiple contact nerve electrodes with spatial selectivity for the control of limb motion by peripheral nerve stimulation even with limited individual muscle selectivity. This technology could be useful to restore neural function in patients with paralysis.     

Effect of hip flexion angle on stiffness of the adductor longus muscle during isometric hip flexion

This study examined the effect of hip flexion angle on the stiffness of the adductor longus (AL) muscle during isometric hip flexion. Seventeen men were recruited. Ten participants performed submaximal voluntary contraction at 0%, 25%, 50%, and 75% of maximal voluntary contraction (MVC) during isometric hip flexion after performing MVC at 0°, 40°, and 80° of hip flexion. Seven participants performed submaximal voluntary tasks during isometric hip extension in addition to hip flexion task. The shear modulus of the AL muscle was used as the index of muscle stiffness, and was measured using ultrasound shear-wave elastography during the tasks at each contraction intensity for each hip flexion angle. During hip flexion, the shear modulus of the AL muscle was higher at 0° than at 40° and 80° of hip flexion at each contraction intensity (p < 0.016). Conversely, a significant effect was not found among hip flexion angle during hip extension at 75% of MVC (p = 0.867). These results suggest that mechanical stress of the AL muscle may be higher at 0° of hip flexion during isometric hip flexion.     

Finger joint impedance during tapping on a computer keyswitch

We studied the dynamic behavior of finger joints during the contact period of tapping on a computer keyswitch, to characterize and parameterize joint function with a lumped-parameter impedance model. We tested the hypothesis that the metacarpophalangeal (MCP) and interphalangeal (IP) joints act similarly in terms of kinematics, torque, and energy production when tapping. Fifteen human subjects tapped with the index finger of the right hand on a computer keyswitch mounted on a two-axis force sensor, which measured forces in the vertical and sagittal planes. Miniature fiber-optic goniometers mounted across the dorsal side of each joint measured joint kinematics. Joint torques were calculated from endpoint forces and joint kinematics using an inverse dynamic algorithm. For each joint, a linear spring and damper model was fitted to joint torque, position, and velocity during the contact period of each tap (22 per subject on average). The spring-damper model could account for over 90% of the variance in torque when loading and unloading portions of the contact were separated, with model parameters comparable to those previously measured during isometric loading of the finger. The finger joints functioned differently, as illustrated by energy production during the contact period. During the loading phase of contact the MCP joint flexed and produced energy, whereas the proximal and distal IP joints extended and absorbed energy. These results suggest that the MCP joint does work on the interphalangeal joints as well as on the keyswitch.     

Postural maintenance during movement: Simulations of a two joint model

Voluntary movements of the upper body are accompanied by anticipatory postural adjustments to the lower body in a standing subject. The long-standing hypothesis is that these anticipatory adjustments serve to counteract the perturbation to the body's center of gravity caused by the voluntary arm movement. This paper presents model simulations investigating the possible roles of anticipatory postural activity that accompanies a rapid, upward arm swing. The model encorporates two (idealized) antagonistic muscle pairs controlling the movements of a double-joint system, with a shoulder joint between the arm and stiff body links, and an ankle joint between the stiff body-leg segment and the ground. Each muscle is represented by a nonlinear viscoelastic element and also includes proprioceptive feedback. Four inputs to the model define the motor control signals for muscle force generation in both the arm and the postural muscle pairs. The neurological component of the model describes consequences of alternate strategies for cocontractions, stretch reflex activity, and anticipatory and synchronous postural activities (or combinations thereof). Simulations with this model show that: (1) none of the postural maintenance schemes considered in these simulations (including varying anticipation) could suppress the initial backward thrust on the body link; (2) the more important destabilizing perturbation is a subsequent forward sway that, left uncountered by postural activity, would eventually leave the body to fall flat on its face; and (3) anticipatory silencing of the postural extensor followed by a brief period of extensor activation (descending control) and synchronous reflex activity (feedback control) appears to be the most likely postural stabilizing strategy that inhibits the continuous forward sway and is consistent with the experimental evidence.     

Estimations of relative effort during sit-to-stand increase when accounting for variations in maximum voluntary torque with joint angle and angular velocity

The main purpose of this study was to compare three methods of determining relative effort during sit-to-stand (STS). Fourteen young (mean 19.6 ± SD 1.2 years old) and 17 older (61.7 ± 5.5 years old) adults completed six STS trials at three speeds: slow, normal, and fast. Sagittal plane joint torques at the hip, knee, and ankle were calculated through inverse dynamics. Isometric and isokinetic maximum voluntary contractions (MVC) for the hip, knee, and ankle were collected and used for model parameters to predict the participant-specific maximum voluntary joint torque. Three different measures of relative effort were determined by normalizing STS joint torques to three different estimates of maximum voluntary torque. Relative effort at the hip, knee, and ankle were higher when accounting for variations in maximum voluntary torque with joint angle and angular velocity (hip = 26.3 ± 13.5%, knee = 78.4 ± 32.2%, ankle = 27.9 ± 14.1%) compared to methods which do not account for these variations (hip = 23.5 ± 11.7%, knee = 51.7 ± 15.0%, ankle = 20.7 ± 10.4%). At higher velocities, the difference in calculating relative effort with respect to isometric MVC or incorporating joint angle and angular velocity became more evident. Estimates of relative effort that account for the variations in maximum voluntary torque with joint angle and angular velocity may provide higher levels of accuracy compared to methods based on measurements of maximal isometric torques.     

Effect of cup abduction angle and head lateral microseparation on contact stresses in ceramic-on-ceramic total hip arthroplasty

A finite elements model was developed in order to evaluate the combined influence of the head lateral microseparation and the cup abduction angle on the contact pressure in Ceramic-on-Ceramic Total Hip Arthroplasty. The model's parameters were those used on the Leeds II hip simulator. A 32 mm head diameter and a 30 μm radial clearance was used. The cup was positioned with an abduction angle ranging from 45° to 90°. The medio-lateral microseparation varied from 0 to 500 μm. A load of 2500 N was applied through the head centre. For 45° abduction angle, edge loading appeared above a medial-lateral separation of 30 μm. Complete edge loading was obtained for a 60 μm medial-lateral separation. Under edge loading conditions, the contact area was found to be elliptical. For 45° abduction angle, as the head lateral separation increased, the maximal contact pressure increased from 66 MPa and converged to an asymptotic value of 205 MPa. Both cup abduction and lateral microseparation displacement induced a large increase in the stresses in Ceramic-on-Ceramic THA. However, this increase in contact pressure induced by higher abduction angle, became negligible as the lateral separation increased.     

Influence of altered gait patterns on the hip joint contact forces

Children who exhibit gait deviations often present a range of bone deformities, particularly at the proximal femur. Altered gait may affect bone growth and lead to deformities by exerting abnormal stresses on the developing bones. The objective of this study was to calculate variations in the hip joint contact forces with different gait patterns. Muscle and hip joint contact forces of four children with different walking characteristics were calculated using an inverse dynamic analysis and a static optimisation algorithm. Kinematic and kinetic analyses were based on a generic musculoskeletal model scaled down to accommodate the dimensions of each child. Results showed that for all the children with altered gaits both the orientation and magnitude of the hip joint contact force deviated from normal. The child with the most severe gait deviations had hip joint contact forces 30% greater than normal, most likely due to the increase in muscle forces required to sustain his crouched stance. Determining how altered gait affects joint loading may help in planning treatment strategies to preserve correct loading on the bone from a young age.     

Flocculation in brewing yeasts: a computer simulation study

A new simulator, INDISIM-FLOC, based on the individual-based simulator INDISIM, is used to examine the predictions of two different models of yeast flocculation. The first, proposed by Calleja is known as the "addition" model. The second, proposed by Stratford is known as the "cascade" model. The simulations show that the latter exhibits a better qualitative agreement with available experimental data.     

Dynamic balance control during sit-to-stand movement: an examination with the center of mass acceleration

The purpose of this study was to establish the region of stability of balance control using the center of mass (COM) acceleration and to characterize age-related differences during sit-to-stand (STS) movement. Whole body motion data were collected from 10 young and 10 elderly subjects while performing STS at their self-selected manners. In addition, young subjects were asked to perform another block of trials with their trunk purposely bent forward prior to seat-off. With the use of a single-link-plus-foot inverted pendulum model, boundaries for the region of stability were determined based on the COM position at seat-off and its instantaneous velocity or its peak acceleration (ROSv or ROSa, respectively). No significant group differences were detected in COM velocities at seat-off. However, peak COM accelerations differed significantly between groups and conditions. This suggested that even though a similar COM momentum was observed at seat-off, this momentum was controlled differently prior to seat-off. Young and elderly subjects utilized similar strategies but with different COM acceleration profiles to perform STS. Furthermore, data from an elderly subject who complained of difficulty in STS during the experiment were located outside the forward boundary of the ROSa, demonstrating a potential use of ROSa to differentiate individuals with declined balance control ability. The ROSa could provide insights into how the COM is controlled prior to seat-off, which may allow us to better identify elderly individuals who are most likely at a risk for imbalance or falls.     

Effect of sub-optimal neuromotor control on the hip joint load during level walking

Skeletal forces are fundamental information in predicting the risk of bone fracture. The neuromotor control system can drive muscle forces with various task- and health-dependent strategies but current modelling techniques provide a single optimal solution of the muscle load sharing problem. The aim of the present work was to study the variability of the hip load magnitude due to sub-optimal neuromotor control strategies using a subject-specific musculoskeletal model. The model was generated from computed tomography (CT) and dissection data from a single cadaver. Gait kinematics, ground forces and electromyographic (EMG) signals were recorded on a body-matched volunteer. Model results were validated by comparing the traditional optimisation solution with the published hip load measurements and the recorded EMG signals. The solution space of the instantaneous equilibrium problem during the first hip load peak resulted in 10(5) dynamically equivalent configurations of the neuromotor control. The hip load magnitude was computed and expressed in multiples of the body weight (BW). Sensitivity of the hip load boundaries to the uncertainty on the muscle tetanic stress (TMS) was also addressed. The optimal neuromotor control induced a hip load magnitude of 3.3 BW. Sub-optimal neuromotor controls induced a hip load magnitude up to 8.93 BW. Reducing TMS from the maximum to the minimum the lower boundary of the hip load magnitude varied moderately whereas the upper boundary varied considerably from 4.26 to 8.93 BW. Further studies are necessary to assess how far the neuromotor control can degrade from the optimal activation pattern and to understand which sub-optimal controls are clinically plausible. However we can consider the possibility that sub-optimal activations of the muscular system play a role in spontaneous fractures not associated with falls.     

Influence of the relative difference in chair seat height according to different lower thigh length on floor reaction force and lower-limb strength during sit-to-stand movement

Chair-seat height affects the burden on the lower-limbs during sit-to-stand (STS) movement. Previous studies used the same height chair, attaching importance to practicability, but the difference in each subject's lower thigh length may relate to the burden on the lower-limbs. This study aimed to examine the influence of different lower thigh lengths on floor reaction force and lower-limb strength during an STS movement. Thirty young-adult male subjects participated in this study (age: 22.7+/-2.6 yr, height: 172.8+/-4.8 cm, body-mass: 66.3+/-5.2 kg). The subjects were divided into three groups (G1>42 cm, 42 cm > or =G2 > or =38 cm, 38 cm >G3) based on lower thigh length (G1: 44.1+/-2.5 cm, G2: 39.8+/-1.3 cm, G3: 34.3+/-2.1 cm). Namely, G1 was characterized by lower thigh length longer than 105% of 40 cm, G2 by 95-105% of lower thigh length and G3 by lower thigh length less than 95% of 40 cm, respectively. Subjects performed an STS movement twice from chairs at 40 cm-height and height adjusted by the lower thigh length of each subject. Vertical floor reaction force and electromyogram (EMG) on the rectus femoris and tibialis anterior muscles during an STS movement were measured to evaluate the force of knocking over and the burden on the lower-limbs. Fifteen parameters regarding floor reaction force (10) and EMG (5) were selected for analyses. Significant differences were found in floor reaction force at hip-syneresis (F1) and the impulse between hip-syneresis and appearance of the peak floor reaction force (F2). G1 was greater than G2 for the former, and G3 for the latter. Significant differences were found in active muscle mass of the tibialis anterior from the beginning of an STS movement to hip-syneresis (TE1) and peak active muscle level of the tibialis anterior (TE6). G1 was greater than G2 for the former, and G2 and G3 for the latter. It was suggested that when an STS movement is performed using a chair with the same height for each subject, the load imposed on the subject's leg at the time of an STS movement and the STS movement achievement strategy differed since chair seat height changes relatively by the difference in lower thigh length. Moreover, it is thought that the difference in these load conditions and movement strategies occurs when the chair seat height of a subject's lower thigh length is longer than 110%. When conducting the ability to achieve STS movement rating test, chair seat height considering each subject's lower thigh length may be needed.     

The structure of percolated polymer systems: a computer simulation study

We studied the percolation process in a system consisting of long flexible polymer chains and solvent molecules. The polymer chains were approximated by linear sequences of beads on a two-dimensional triangular lattice. The system was athermal and the excluded volume was the only potential. The properties of the model system across the entire range of polymer concentrations were determined by Monte Carlo simulations employing a cooperative motion algorithm (CMA). The scaling behavior and the structure of the percolation clusters are presented and discussed.     

An examination of possible quadriceps force at the time of anterior cruciate ligament injury during landing: A simulation study

Anterior cruciate ligament (ACL) rupture is a common and traumatic injury. Although, identifying the mechanism of ACL injury has received considerable research attention, there are still many unanswered questions. One proposed mechanism asserts that the ACL is injured due to an aggressive quadriceps muscle contraction. However, recently it has been questioned if the magnitude of quadriceps force needed to tear the ACL is physiologically realistic under the conditions where injury occurs during landing (e.g. near full knee extension and within 50ms after impact). To answer this question, a simple simulation model was developed to examine the upper bounds of quadriceps force that can be developed under these conditions. The model included force-length, and force-velocity properties as well as activation dynamics. Model parameters were chosen to provide a high estimate for possible quadriceps force in a young healthy man. The effects of varying quadriceps pre-activation levels were also examined. When using realistic pre-activation levels, the simulated quadriceps force was less than half of what has been shown to cause ACL injury. Even when using maximum pre-activation, the quadriceps force still did not reach close to the level shown to cause injury. Therefore, we conclude that quadriceps force alone seems to be an unlikely mechanism for ACL injury.     

Transcription regulation by steroid hormones: a computer simulation study.

Three-dimensional structures of complexes of 66 amino acid-DNA binding domains of human progesterone (hPR), estrogen (hER) and glucocorticoid (hGR) receptors (proteins), with ten base pair DNA duplexes: d(AGGTCATGCT).d(AGCATGACCT) and d(AGAACATGCT).d(AGCATGTTCT) were obtained using computer modeling and molecular mechanics techniques. Cartesian coordinates for the proteins were obtained from: 1) structural data of hER and hGR by NMR spectroscopy; 2) steric constraints imposed by tetrahedral coordination of the zinc ion to Cys residues, and 3) energy minimization in torsional and cartesian space. The proteins were made to interact with DNA (in B-form) in major groove through alpha-helical linker between the two zinc fingers. The geometry of the complexes was obtained by allowing them to slide, glide, penetrate in to and out of the groove, and to rotate about the helical axis. The complexes were energy minimized. Also maximized was the number of H-bonds between proteins and DNA. The complex structures were refined by molecular mechanics using AMBER 3.0. Structural parameters of DNA were analyzed in each complex and compared with those of native DNA optimized separately. The stereochemical differences of the complexes are discussed.