On the biomechanics of human shoulder complex--II. Passive resistive properties beyond the shoulder complex sinus

In multi-segmented total-human-body models the most difficult and the least successful modeling of a major articulating joint has been the shoulder complex because of the lack of appropriate biomechanical data as well as the anatomical complexity of the region. In this paper, quantitative results on the three-dimensional passive resistive properties beyond the voluntary shoulder complex sinus are presented by applying the methodology developed in part I. Constant-restoring-force(moment) contours are established for the shoulder complex and the numerical results are presented for the three subjects tested. In addition, functional expansions are presented for the voluntary and restoring force(moment) contours using spherical coordinates.     

Statistical data base for the biomechanical properties of the human shoulder complex--II: Passive resistive properties beyond the shoulder complex sinus

In mathematical modeling of multi-segmented articulating total-human-body, there is no doubt that the shoulder complex plays one of the most important roles. However, proper biomechanical passive resistive force data have been lacking in the literature. This paper presents determination of the three-dimensional passive resistive joint properties beyond the maximal voluntary shoulder complex sinus. A functional expansion with two spherical angular variables in the local joint axis system is proposed to fit the overall restoring force (moment) data. A constant restoring force (moment) contour map as well as a three-dimensional perspective view of the results are presented in a new coordinate system defined in this study. Finally, a statistical data base is established by utilizing the statistical analysis procedures discussed in Part I of this paper.     

Kinematic and passive resistive properties of human elbow complex

In recent years, owing to their versatility and reduced cost of operation, multisegmented mathematical models of the total human body have gained increased attention in gross biodynamic motion studies. This, in turn, has stimulated the need for a proper biomechanical data base for the major human articulating joints. The lack of such a database for the humero-elbow complex is the impetus for this study. The total angular range of motion permitted by the complex and the passive resistive properties beyond the full elbow extension were studied. Results obtained on ten normal male subjects were utilized to establish a statistical data base for the humero-elbow complex. Results are also expressed in functional expansion form suitable for incorporation into the existing multisegmented models.     

Total shoulder and relative muscle strength in the scapular plane.

Strength profiles of the shoulder joint are measured experimentally for two arm positions in "the scapular plane" in order to present quantitative data on the shoulder strength. Apart from yielding the actual force a subject can exert in various directions, these measurements also exhibit e.g. the strongest and weakest directions, in fact the relative strength in all directions. The inter-individual variation of the direction of maximal force was at most 14 degrees (sd). The experimental profiles are compared with the corresponding theoretical profiles, obtained by using a shoulder model. The calculations were made both with default muscle parameters and individually adapted parameters. The results show that the employed shoulder model, which is based on data from an elderly population, may be adapted to other populations and that the necessary changes in relative muscle strength are those expected on biomechanical grounds. Without model changes the difference between measured (in the mean) and predicted maximal force directions was at most 50 degrees. Muscle parameter adjustment reduced this difference to 23 degrees. The strength profiles clearly indicate in what direction a person can produce larger forces and which muscles that contribute.     

Evaluation of regression-based 3-D shoulder rhythms

The movements of the humerus, the clavicle, and the scapula are not completely independent. The coupled pattern of movement of these bones is called the shoulder rhythm. To date, multiple studies have focused on providing regression-based 3-D shoulder rhythms, in which the orientations of the clavicle and the scapula are estimated by the orientation of the humerus. In this study, six existing regression-based shoulder rhythms were evaluated by an independent dataset in terms of their predictability. The datasets include the measured orientations of the humerus, the clavicle, and the scapula of 14 participants over 118 different upper arm postures. The predicted orientations of the clavicle and the scapula were derived from applying those regression-based shoulder rhythms to the humerus orientation. The results indicated that none of those regression-based shoulder rhythms provides consistently more accurate results than the others. For all the joint angles and all the shoulder rhythms, the RMSE are all greater than 5°. Among those shoulder rhythms, the scapula lateral/medial rotation has the strongest correlation between the predicted and the measured angles, while the other thoracoclavicular and thoracoscapular bone orientation angles only showed a weak to moderate correlation. Since the regression-based shoulder rhythm has been adopted for shoulder biomechanical models to estimate shoulder muscle activities and structure loads, there needs to be further investigation on how the predicted error from the shoulder rhythm affects the output of the biomechanical model.     

Shoulder joint kinematics during elevation measured by ultrasound-based measuring system.

In order to analyze shoulder joint movements, the authors use a ZEBRIS CMS-HS ultrasound-based movement analysis system. In essence, the measurement involves the determination of the spatial position of the 16 anatomical points, which are specified on the basis of the coordinates of ultrasound-based triplets positioned on the upper limb, the scapula, and the thorax; their spatial position is measured in the course of motion. Kinematic characteristics of 74 shoulder joints of 50 healthy persons were identified during elevation in the plane of the scapula. Kinematic characteristics of motion were identified by scapulothoracic, glenohumeral, and humeral elevation angles; range of angles; scapulothoracis and glenohumeral rhythm; scapulothoracic, glenohumeral, and scapuloglenoid ratios; and the relative displacement between the rotation centers of the humerus and the scapula. Motion of the humerus and the scapula relative to each other was characterized by their rotation as well as the relative displacement between the rotation centers of scapula and humerus. The biomechanical model of the shoulder joint during elevation can be described by analyzing the results of the measurements performed.     

A comprehensive and volumetric musculoskeletal model for the dynamic simulation of the shoulder function

We present a volumetric and extensive finite element model of the shoulder usable in the context of inverse control, in which the scapula is left unconstrained on the ribcage. Such a model allows for exploring various shoulder movements, which are essential for making patient-specific decisions. The proposed model consists of 23 volumetric muscles parts modelled using the finite element method. The glenohumeral, acromioclavicular and sternoclavicular joints are modelled with soft ball-socket constraints. The musculoskeletal model can be controlled by a tracking-based algorithm, finding the excitations values in the muscles needed to follow some target points. The moment arms obtained during abduction and rotation are compared with the literature, which includes results from cadaveric data and a fine FE model of the rotator cuff and the deltoid. We simulated the paralysis of serratus anterior, a main reason of scapular winging, and compared it with its physiological counterpart. A deficiency in the range of motion as well as a reduction in upward rotation were observed, which both corroborate clinical observations. This is one of the most comprehensive model of the shoulder, which can be used to study complex pathologies of the shoulder and their impact on functional outcome such as range-of-motion.     

A regression-based 3-D shoulder rhythm

In biomechanical modeling of the shoulder, it is important to know the orientation of each bone in the shoulder girdle when estimating the loads on each musculoskeletal element. However, because of the soft tissue overlying the bones, it is difficult to accurately derive the orientation of the clavicle and scapula using surface markers during dynamic movement. The purpose of this study is to develop two regression models which predict the orientation of the clavicle and the scapula. The first regression model uses humerus orientation and individual factors such as age, gender, and anthropometry data as the predictors. The second regression model includes only the humerus orientation as the predictor. Thirty-eight participants performed 118 static postures covering the volume of the right hand reach. The orientation of the thorax, clavicle, scapula and humerus were measured with a motion tracking system. Regression analysis was performed on the Euler angles decomposed from the orientation of each bone from 26 randomly selected participants. The regression models were then validated with the remaining 12 participants. The results indicate that for the first model, the r² of the predicted orientation of the clavicle and the scapula ranged between 0.31 and 0.65, and the RMSE obtained from the validation dataset ranged from 6.92° to 10.39°. For the second model, the r² ranged between 0.19 and 0.57, and the RMSE obtained from the validation dataset ranged from 6.62° and 11.13°. The derived regression-based shoulder rhythm could be useful in future biomechanical modeling of the shoulder.     

A kinematic model of the shoulder complex to evaluate the arm-reachable workspace

Upper-arm evaluation including shoulder motion in physiotherapy has no three-dimensional tool for an arm-functioning evaluation, which hampers an uniform, objective comparison. Human shoulder complex models suffer from lack of shoulder girdle kinematic data. A kinematic shoulder-complex model with six degrees of freedom is proposed as the composition of the inner joint representing the shoulder-girdle joints and outer joint representing the glenohumeral joint. The outer shoulder joint has three perpendicular rotations: adduction/abduction, retroflexion/flexion and internal/external rotation of the humerus. The inner shoulder joint has two rotations, depression/elevation and retraction/protraction, and one translation, which are all dependent on the elevation angle of the humerus. The human arm-reachable workspace that represents the area within reach of the wrist is calculated on the basis of the shoulder-complex model and the additional elbow-joint direct kinematics. It was demonstrated that cross-sections of the calculated workspace are in agreement with the measured arm-reachable workspace in all three anatomical planes. The arm-reachable workspace volume and graphics were calculated and a comparison of the arm's workspaces during a patient's shoulder treatment was made. The obtained numerical and graphical arm-reachable workspaces can be used for arm-functioning evaluations in rehabilitation and ergonomics.     

Development and evaluation of the measurement system for the human shoulder joint based on the 6 DOF kinematic modelling

Although numerical models on the shoulder complex joint are currently available, many are impractical because of the procedural complexity coupled with limited and mere simple simulations. The present study defined the clavicle-scapula system as the "base of the humerus" in determining the position of proximal head of humerus, rendering conclusive innovation of a six degree of freedom (DOF) shoulder complex joint model. Furthermore, a complete measurement system where evaluation by calibrating the actual values via the use of an electromagnetic tracking device (ETD) was developed based on the innovated model. The special calibration method using optimizing calculation to work out the rotational center of humerus was employed and actually tested if the theoretical consideration was practically available. As a result of accuracy check experiments, the measurement error was defined within 2-3 mm, indicating sufficient accuracy in studies for human movement. Our findings strongly advocate that the benefit of this novel measurement system would contribute to studies related to shoulder movements in physiological anthropology.     

A mathematical musculoskeletal shoulder model for proactive ergonomic analysis

Occupational shoulder musculoskeletal injuries and disorders are common. Generally available shoulder work analysis tools do not offer insight into specific muscle load magnitudes that may indicate increased risk, nor do they address many concerns germane to job analysis. To address these issues, a biomechanical model of the shoulder was developed to include several critical components: the systematic inclusion of kinematic and kinetic effects, population scalability, geometric realism, an empirical glenohumeral constraint, and integration with digital ergonomics analysis software tools. This unique combination of features in a single model was explored through examination of both experimental and simulated data with the developed analysis tool. The utility of the model is discussed together with a review of its specific strengths and weaknesses, and the potential for its future use in proactive ergonomic analyses and workplace simulations.     

A mathematical musculoskeletal shoulder model for proactive ergonomic analysis

Occupational shoulder musculoskeletal injuries and disorders are common. Generally available shoulder work analysis tools do not offer insight into specific muscle load magnitudes that may indicate increased risk, nor do they address many concerns germane to job analysis. To address these issues, a biomechanical model of the shoulder was developed to include several critical components: the systematic inclusion of kinematic and kinetic effects, population scalability, geometric realism, an empirical glenohumeral constraint, and integration with digital ergonomics analysis software tools. This unique combination of features in a single model was explored through examination of both experimental and simulated data with the developed analysis tool. The utility of the model is discussed together with a review of its specific strengths and weaknesses, and the potential for its future use in proactive ergonomic analyses and workplace simulations.     

On the kinematic modelling and the parameter estimation of the human shoulder.

This paper presents some results on the modelling and the corresponding parameter estimation of the human shoulder. This system consists of the clavicle, the scapula, the humerus and the various joints between these bodies and the trunk through the sternum; it will be represented as a succession of a rotational joint between the sternum and the clavicle and a constant distance joint, representing the scapula between, the clavicle and the humerus head. The parameters of this system are the components of the position vectors of the joint characteristic points (the corresponding centres of the rotations). Experimental results are presented as well as a validation of the proposed model.     

Morphometric affinities of the human shoulder

To analyze differences between apes and monkeys and the affinities of man, we have studied the shoulder girdle of 327 specimens of anthropoid primates. The scapula, clavicle and humerus are viewed as an integrated functional complex on the basis of 18 measurements. Several varieties of multivariate analysis show that man is clearly closer to other hominoids than to the included monkey taxa (whether terrestrial or arboreal, Old World or New World). The marked shoulder differences between apes and monkeys and similarities between apes and man correlate with the muscular anatomy, which in hominoids allows the motions involved in their locomotion and feeding behavior. As the hominid-pongid correspondence in shoulder morphology is especially detailed regarding the functionally important joint surfaces, it is consistent with a fairly recent period of common ancestry and behavior. No hypothetical evolutionary pathway or ancestral form of the human shoulder need look far beyond the model afforded by extant pongids. In contrast with previous studies on the primate shoulder, these results agree with information accumulating from other systems—comparative anatomy, primate behavior, and molecular biology — in suggesting very close relationship between man and extant African pongids.