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We sought to provide a more comprehensive understanding of how the individual leg muscles act synergistically to generate a ground force impulse and maximize the change in forward momentum of the body during accelerated sprinting. We combined musculoskeletal modelling with gait data to simulate the majority of the acceleration phase (19 foot contacts) of a maximal sprint over ground. Individual muscle contributions to the ground force impulse were found by evaluating each muscle's contribution to the vertical and fore-aft components of the ground force (termed "supporter" and "accelerator/brake," respectively). The ankle plantarflexors played a major role in achieving maximal-effort accelerated sprinting. Soleus acted primarily as a supporter by generating a large fraction of the upward impulse at each step whereas gastrocnemius contributed appreciably to the propulsive and upward impulses and functioned as both accelerator and supporter. The primary role of the vasti was to deliver an upward impulse to the body (supporter), but these muscles also acted as a brake by retarding forward momentum. The hamstrings and gluteus medius functioned primarily as accelerators. Gluteus maximus was neither an accelerator nor supporter as it functioned mainly to decelerate the swinging leg in preparation for foot contact at the next step. Fundamental knowledge of lower-limb muscle function during maximum acceleration sprinting is of interest to coaches endeavoring to optimize sprint performance in elite athletes as well as sports medicine clinicians aiming to improve injury prevention and rehabilitation practices., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim of this study was to develop a generic musculoskeletal model of a healthy 10-year-old child and examine the effects of geometric scaling on the calculated values of lower-limb muscle forces during gait. Subject-specific musculoskeletal models of five healthy children were developed from in vivo MRI data, and these models were subsequently used to create a generic juvenile (GJ) model. Calculations of lower-limb muscle forces for normal walking obtained from two scaled-generic versions of the juvenile model (SGJ1 and SGJ2) were evaluated against corresponding results derived from an MRI-based model of one subject (SSJ1). The SGJ1 and SGJ2 models were created by scaling the GJ model using gait marker positions and joint centre locations derived from MRI imaging, respectively. Differences in the calculated values of peak isometric muscle forces and muscle moment arms between the scaled-generic models and MRI-based model were relatively small. Peak isometric muscle forces calculated for SGJ1 and SGJ2 were respectively 2.2% and 3.5% lower than those obtained for SSJ1. Model-predicted muscle forces for SGJ2 agreed more closely with calculations obtained from SSJ1 than corresponding results derived from SGJ1. These results suggest that accurate estimates of muscle forces during gait may be obtained by scaling generic juvenile models based on joint centre locations. The generic juvenile model developed in this study may be used as a template for creating subject-specific musculoskeletal models of normally-developing children in studies aimed at describing lower-limb muscle function during gait.

Accurate knowledge of knee joint motion is needed to evaluate the effects of implant design on functional performance and component wear. We conducted a randomized controlled trial to measure and compare 6-degree-of-freedom (6-DOF) kinematics and femoral condylar motion of posterior-stabilized (PS), cruciate-retaining (CR), and medial-stabilized (MS) knee implant designs for one cycle of walking. A mobile biplane X-ray imaging system was used to accurately measure 6-DOF tibiofemoral motion as patients implanted with PS (n = 23), CR (n = 25), or MS (n = 26) knees walked over ground at their self-selected speeds. Knee flexion angle did not differ significantly between the three designs. Relative movements of the femoral and tibial components were generally similar for PS and CR with significant differences observed only for anterior tibial drawer. Knee kinematic profiles measured for MS were appreciably different: external rotation and abduction of the tibia were increased while peak-to-peak anterior drawer was significantly reduced for MS compared with PS and CR. Anterior-posterior drawer and medial-lateral shift of the tibia were strongly coupled to internal-external rotation for MS, as was anterior-posterior translation of the contact center in the lateral compartment. MS exhibited the least amount of paradoxical anterior translation of the femur relative to the tibia during knee flexion. The joint center of rotation in the transverse plane was located in the lateral compartment for PS and CR and in the medial compartment for MS. Substantial differences were evident in 6-DOF knee kinematics between the healthy knee and all three prosthetic designs. Overall, knee kinematic profiles observed for MS resemble those of the healthy joint more closely than PS and CR., (© 2020 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)

Background: The efficacy of foot orthoses in reducing patellofemoral pain (PFP) is well documented; however, the mechanisms by which foot orthoses modulate pain and function are poorly understood., Research Question: This within-subject study investigated the immediate effects of foot orthoses on lower limb kinematics and angular impulses during level walking and stair ambulation in individuals with persistent PFP., Methods: Forty-two participants with persistent PFP (≥3 months duration) underwent quantitative gait analysis during level walking, stair ascent and stair descent while using: (i) standard running sandals (control); and (ii) standard running sandals fitted with prefabricated foot orthoses. Hip, knee, and ankle joint kinematics and angular impulses were calculated and statistically analyzed using paired t-tests (p < 0.05)., Results: Relative to the control condition, foot orthoses use was associated with small but significant decreases in maximum ankle inversion angles during walking (mean difference [95% confidence interval]: -1.00° [-1.48 to -0.53]), stair ascent (-1.06° [-1.66 to -0.45]) and stair decent (-0.94° [-1.40 to -0.49]). Foot orthoses were also associated with decreased ankle eversion impulse during walking (-9.8Nms/kg [-12.7 to -6.8]), and decreased ankle dorsiflexion and eversion impulse during stair ascent (-67.6Nms/kg [-100.7 to -34.6] and -17.5Nms/kg [-23.6 to -11.4], respectively) and descent (-50.4Nms/kg [-77.2 to -23.6] and -11.6Nms/kg [-15.6 to -7.5], respectively). Ankle internal rotation impulse decreased when participants ascended stairs with foot orthoses (-3.3Nms/kg [-5.4 to -1.3]). Limited changes were observed at the knee and hip., Significance: In individuals with persistent PFP, small immediate changes in kinematics and angular impulses - primarily at the ankle - were observed when foot orthoses were worn during walking or stair ambulation. The clinical implications of these small changes, as well as the longer-term effects of foot orthoses on lower limb biomechanics, are yet to be determined., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2020 Elsevier B.V. All rights reserved.)

We implemented direct collocation on a full-body neuromusculoskeletal model to calculate muscle forces, ground reaction forces and knee contact loading simultaneously for one cycle of human gait. A data-tracking collocation problem was solved for walking at the normal speed to establish the practicality of incorporating a 3D model of articular contact and a model of foot-ground interaction explicitly in a dynamic optimization simulation. The data-tracking solution then was used as an initial guess to solve predictive collocation problems, where novel patterns of movement were generated for walking at slow and fast speeds, independent of experimental data. The data-tracking solutions accurately reproduced joint motion, ground forces and knee contact loads measured for two total knee arthroplasty patients walking at their preferred speeds. RMS errors in joint kinematics were < 2.0° for rotations and < 0.3 cm for translations while errors in the model-computed ground-reaction and knee-contact forces were < 0.07 BW and < 0.4 BW, respectively. The predictive solutions were also consistent with joint kinematics, ground forces, knee contact loads and muscle activation patterns measured for slow and fast walking. The results demonstrate the feasibility of performing computationally-efficient, predictive, dynamic optimization simulations of movement using full-body, muscle-actuated models with realistic representations of joint function.

Background: Torsional deformities of the femur and tibia are associated with gait impairments and joint pain. Several studies have investigated these gait deviations in children with cerebral palsy. However, relatively little is known about gait deviations in children with idiopathic torsion and debate ensues about the management of these patients., Research Question: What are the effects of idiopathic increased femoral neck anteversion and external tibial torsion on lower-limb kinematics, kinetics and joint loading during gait in children and adolescents., Methods: Patient-specific musculoskeletal models were created for 12 children/adolescents (mean age of 14 years) with torsional deformities using low-dose biplane radiographic imaging and 3D gait analysis. Comparisons of joint motion and net joint torques during gait were made to an age-matched control group with no torsional deformities. The effects of torsional deformities on muscle and joint contact forces were investigated using two personalised musculoskeletal models: one with normal torsion and another with patient-specific torsion., Results: Femoral neck anteversion and external tibial torsion for the patients were (mean ± SD) 38° ± 9° and 40° ± 10°, respectively. Patients had increased internal hip rotation and external knee rotation as well as increased pelvic tilt during gait. Additionally, the efficacy of the plantarflexor-knee extension mechanism was diminished. Hip joint contact force was higher in the model with patient-specific torsion. The mediolateral component of the patellofemoral joint contact force was also increased despite the magnitude of the resultant patellofemoral contact force being unchanged., Significance: It has been previously established that idiopathic lower-limb torsional deformities alter gait kinematics. However, this study also showed that loading of the hip and patellofemoral joints are increased. This is an important insight for the clinical management of these patients and highlights that idiopathic lower-limb torsional deformities are not a purely cosmetic issue., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The aim of this study was to perform multi-body, muscle-driven, forward-dynamics simulations of human gait using a 6-degree-of-freedom (6-DOF) model of the knee in tandem with a surrogate model of articular contact and force control. A forward-dynamics simulation incorporating position, velocity and contact force-feedback control (FFC) was used to track full-body motion capture data recorded for multiple trials of level walking and stair descent performed by two individuals with instrumented knee implants. Tibiofemoral contact force errors for FFC were compared against those obtained from a standard computed muscle control algorithm (CMC) with a 6-DOF knee contact model (CMC6); CMC with a 1-DOF translating hinge-knee model (CMC1); and static optimization with a 1-DOF translating hinge-knee model (SO). Tibiofemoral joint loads predicted by FFC and CMC6 were comparable for level walking, however FFC produced more accurate results for stair descent. SO yielded reasonable predictions of joint contact loading for level walking but significant differences between model and experiment were observed for stair descent. CMC1 produced the least accurate predictions of tibiofemoral contact loads for both tasks. Our findings suggest that reliable estimates of knee-joint loading may be obtained by incorporating position, velocity and force-feedback control with a multi-DOF model of joint contact in a forward-dynamics simulation of gait., (Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.)

The aim of this study was to evaluate the accuracy with which mobile biplane X-ray imaging can be used to measure patellofemoral kinematics of the intact knee during overground gait. A unique mobile X-ray imaging system tracked and recorded biplane fluoroscopic images of two human cadaver knees during simulated overground walking at a speed of 0.7m/s. Six-degree-of-freedom patellofemoral kinematics were calculated using a bone volumetric model-based method and the results then compared against those derived from a gold-standard bead-based method. RMS errors for patellar anterior translation, superior translation and lateral shift were 0.19mm, 0.34mm and 0.37mm, respectively. RMS errors for patellar flexion, lateral tilt and lateral rotation were 1.08°, 1.15° and 1.46°, respectively. The maximum RMS error for patellofemoral translations was approximately one-half that reported previously for tibiofemoral translations using the same mobile X-ray imaging system while the maximum RMS error for patellofemoral rotations was nearly two times larger than corresponding errors reported for tibiofemoral rotations. The lower accuracy in measuring patellofemoral rotational motion is likely explained by the symmetric nature of the patellar geometry and the smaller size of the patella compared to the tibia., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The aim of this study was to quantify the effects of step length and step frequency on lower-limb muscle function in walking. Three-dimensional gait data were used in conjunction with musculoskeletal modeling techniques to evaluate muscle function over a range of walking speeds using prescribed combinations of step length and step frequency. The body was modeled as a 10-segment, 21-degree-of-freedom skeleton actuated by 54 muscle-tendon units. Lower-limb muscle forces were calculated using inverse dynamics and static optimization. We found that five muscles - GMAX, GMED, VAS, GAS, and SOL - dominated vertical support and forward progression independent of changes made to either step length or step frequency, and that, overall, changes in step length had a greater influence on lower-limb joint motion, net joint moments and muscle function than step frequency. Peak forces developed by the uniarticular hip and knee extensors, as well as the normalized fiber lengths at which these muscles developed their peak forces, correlated more closely with changes in step length than step frequency. Increasing step length resulted in larger contributions from the hip and knee extensors and smaller contributions from gravitational forces (limb posture) to vertical support. These results provide insight into why older people with weak hip and knee extensors walk more slowly by reducing step length rather than step frequency and also help to identify the key muscle groups that ought to be targeted in exercise programs designed to improve gait biomechanics in older adults., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Most X-ray fluoroscopy systems are stationary and impose restrictions on the measurement of dynamic joint motion; for example, knee-joint kinematics during gait is usually measured with the subject ambulating on a treadmill. We developed a computer-controlled, mobile, biplane, X-ray fluoroscopy system to track human body movement for high-speed imaging of 3D joint motion during overground gait. A robotic gantry mechanism translates the two X-ray units alongside the subject, tracking and imaging the joint of interest as the subject moves. The main aim of the present study was to determine the accuracy with which the mobile imaging system measures 3D knee-joint kinematics during walking. In vitro experiments were performed to measure the relative positions of the tibia and femur in an intact human cadaver knee and of the tibial and femoral components of a total knee arthroplasty (TKA) implant during simulated overground gait. Accuracy was determined by calculating mean, standard deviation and root-mean-squared errors from differences between kinematic measurements obtained using volumetric models of the bones and TKA components and reference measurements obtained from metal beads embedded in the bones. Measurement accuracy was enhanced by the ability to track and image the joint concurrently. Maximum root-mean-squared errors were 0.33 mm and 0.65° for translations and rotations of the TKA knee and 0.78 mm and 0.77° for translations and rotations of the intact knee, which are comparable to results reported for treadmill walking using stationary biplane systems. System capability for in vivo joint motion measurement was also demonstrated for overground gait.

Inverse dynamics analysis is commonly used to estimate the net loads at a joint during human motion. Most lower-limb models of movement represent the knee as a simple hinge joint when calculating muscle forces. This approach is limited because it neglects the contributions from tibiofemoral joint contact forces and may therefore lead to errors in estimated muscle forces. The aim of this study was to quantify the contributions of tibiofemoral joint contact loads to the net knee loads calculated from inverse dynamics for multiple subjects and multiple gait patterns. Tibiofemoral joint contact loads were measured in four subjects with instrumented implants as each subject walked at their preferred speed (normal gait) and performed prescribed gait modifications designed to treat medial knee osteoarthritis. Tibiofemoral contact loads contributed substantially to the net knee extension and knee adduction moments in normal gait with mean values of 16% and 54%, respectively. These findings suggest that knee-contact kinematics and loads should be included in lower-limb models of movement for more accurate determination of muscle forces. The results of this study may be used to guide the development of more realistic lower-limb models that account for the effects of tibiofemoral joint contact at the knee., (© 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)

Patellofemoral joint pain is a common problem experienced by active adults. However, relatively little is known about patellofemoral joint load and its distribution across the medial and lateral facets of the patella. In this study, biomechanical experiments and computational modeling were used to study patellofemoral contact mechanics in four healthy adults during stair ambulation. Subject-specific anatomical and gait data were recorded using magnetic resonance imaging, dynamic X-ray fluoroscopy, video motion capture, and multiple force platforms. From these data, in vivo tibiofemoral joint kinematics and knee muscle forces were computed and then applied to a deformable finite-element model of the patellofemoral joint. The contact force acting on the lateral facet of the patella was 4-6 times higher than that acting on the medial facet. The peak average patellofemoral contact stresses were 8.2±1.0 MPa and 5.9±1.3 MPa for the lateral and medial patellar facets, respectively. Peak normal compressive stress and peak octahedral shear stress occurred near toe-off of the contralateral leg and were higher on the lateral facet than the medial facet; furthermore, the peak compressive stress (11.5±3.0 MPa) was higher than the peak octahedral shear stress (5.2±0.9 MPa). The dominant stress pattern on the lateral patellar facet corresponded well to the location of maximum cartilage thickness. Higher loading of the lateral facet is also consistent with the clinical observation that the lateral compartment of the patellofemoral joint is more prone to osteoarthritis than the medial compartment. Predicted cartilage contact stress maps near contralateral toe-off showed three distinctly different patterns: peak stresses located on the lateral patellar facet; peak stresses located centrally between the medial and lateral patellar facets; and peak stresses located superiorly on both the medial and lateral patellar facets., (Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.)

The human ankle plantar-flexors, the soleus and gastrocnemius, utilize tendon elastic strain energy to reduce muscle fiber work and optimize contractile conditions during running. However, studies to date have considered only slow to moderate running speeds up to 5 m s(-1). Little is known about how the human ankle plantar-flexors utilize tendon elastic strain energy as running speed is advanced towards maximum sprinting. We used data obtained from gait experiments in conjunction with musculoskeletal modeling and optimization techniques to calculate muscle-tendon unit (MTU) work, tendon elastic strain energy and muscle fiber work for the ankle plantar-flexors as participants ran at five discrete steady-state speeds ranging from jogging (~2 m s(-1)) to sprinting (≥8 m s(-1)). As running speed progressed from jogging to sprinting, the contribution of tendon elastic strain energy to the positive work generated by the MTU increased from 53% to 74% for the soleus and from 62% to 75% for the gastrocnemius. This increase was facilitated by greater muscle activation and the relatively isometric behavior of the soleus and gastrocnemius muscle fibers. Both of these characteristics enhanced tendon stretch and recoil, which contributed to the bulk of the change in MTU length. Our results suggest that as steady-state running speed is advanced towards maximum sprinting, the human ankle plantar-flexors continue to prioritize the storage and recovery of tendon elastic strain energy over muscle fiber work., (© 2014. Published by The Company of Biologists Ltd.)

Accurate knowledge of the isolated contributions of joint movements to the three-dimensional displacement of the center of mass (COM) is fundamental for understanding the kinematics of normal walking and for improving the treatment of gait disabilities. Saunders et al. (1953) identified six kinematic mechanisms to explain the efficient progression of the whole-body COM in the sagittal, transverse, and coronal planes. These mechanisms, referred to as the major determinants of gait, were pelvic rotation, pelvic list, stance knee flexion, foot and knee mechanisms, and hip adduction. The aim of the present study was to quantitatively assess the contribution of each major gait determinant to the anteroposterior, vertical, and mediolateral displacements of the COM over one gait cycle. The contribution of each gait determinant was found by applying the concept of an 'influence coefficient', wherein the partial derivative of the COM displacement with respect to a prescribed determinant was calculated. The analysis was based on three-dimensional measurements of joint angular displacements obtained from 23 healthy young adults walking at slow, normal and fast speeds. We found that hip flexion, stance knee flexion, and ankle-foot interaction (comprised of ankle plantarflexion, toe flexion and the displacement of the center of pressure) are the major determinants of the displacements of the COM in the sagittal plane, while hip adduction and pelvic list contribute most significantly to the mediolateral displacement of the COM in the coronal plane. Pelvic rotation and pelvic list contribute little to the vertical displacement of the COM at all walking speeds. Pelvic tilt, hip rotation, subtalar inversion, and back extension, abduction and rotation make negligible contributions to the displacements of the COM in all three anatomical planes., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: To determine whether people with patellofemoral (PF) joint osteoarthritis (OA) ascend and descend stairs with different PF joint loading, knee joint moments, lower limb kinematics, and muscle forces compared to healthy people., Methods: We recruited 17 participants with isolated PF joint OA, 13 participants with concurrent PF joint OA and tibiofemoral (TF) joint OA, and 21 age-matched controls. Joint kinematics and ground reaction forces were measured while participants ascended and descended stairs at a self-selected speed. Musculoskeletal computer modeling was used to determine lower limb muscle forces and the PF joint reaction force, and these parameters were compared between groups by analysis of variance., Results: Compared to their healthy counterparts, participants with isolated PF joint OA and participants with concurrent PF and TF joint OA ascended and descended stairs with lower knee extension moments, lower quadriceps muscle forces, lower PF joint reaction forces, and increased anterior pelvic tilt. Participants with OA also ascended stairs with increased hip flexion angles and descended stairs with smaller knee flexion angles and smaller hip abductor muscle forces. No differences were evident between the two groups with OA., Conclusion: Compared to their healthy counterparts, people with PF joint OA (with or without concurrent TF joint OA) exhibit lower PF joint reaction forces during stair ascent and descent, in conjunction with lower knee extension moments and lower quadriceps muscle forces., (Copyright © 2013 by the American College of Rheumatology.)

Older adults walk more slowly, take shorter steps, and spend more time with both legs on the ground compared to young adults. Although many studies have investigated the effects of aging on the kinematics and kinetics of gait, little is known about the corresponding changes in muscle function. The aim of this study was to describe and compare the actions of the lower-limb muscles in accelerating the body's center of mass (COM) in healthy young and older adults. Three-dimensional gait analysis and subject-specific musculoskeletal modeling were used to calculate lower-limb muscle forces and muscle contributions to COM accelerations when both groups walked at the same speed. The orientations of all body segments during walking, except that of the pelvis, were invariant to age when these quantities were expressed in a global reference frame. The older subjects tilted their pelves more anteriorly during the stance phase. The mean contributions of the gluteus maximus, gluteus medius, vasti, gastrocnemius and soleus to the vertical, fore-aft and mediolateral COM accelerations (support, progression and balance, respectively) were similar in the two groups. However, the gluteus medius contributed significantly less to support (p<0.05) while the gluteus maximus and contralateral erector spinae contributed significantly more to balance (p<0.05) during early stance in the older subjects. These results provide insight into the functional roles of the individual leg muscles during gait in older adults, and highlight the importance of the hip and back muscles in controlling mediolateral balance., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Patients with total knee arthroplasty (TKA) frequently exhibit changes in gait biomechanics post-surgery, including decreased ranges of joint motion and changes in joint loading; however, the actions of the lower-limb muscles in generating joint moments and accelerating the center of mass (COM) during walking are yet to be described. The aim of the present study was to evaluate differences in lower-limb joint kinematics, muscle-generated joint moments, and muscle contributions to COM accelerations in TKA patients and healthy age-matched controls when both groups walk at the same speed. Each TKA patient was fitted with a posterior-stabilized total knee replacement and underwent patellar resurfacing. Three-dimensional gait analysis and subject-specific musculoskeletal modeling were used to determine lower-limb and trunk muscle forces and muscle contributions to COM accelerations during the stance phase of gait. The TKA patients exhibited a 'quadriceps avoidance' gait pattern, with the vasti contributing significantly less to the extension moment developed about the knee during early stance (p=0.036). There was a significant decrease in the contribution of the vasti to the vertical acceleration (support) (p=0.022) and forward deceleration of the COM (braking) (p=0.049) during early stance; however, the TKA patients compensated for this deficiency by leaning their trunks forward. This significantly increased the contribution of the contralateral back extensor muscle (erector spinae) to support (p=0.030), and that of the contralateral back rotators (internal and external obliques) to braking (p=0.004). These findings provide insight into the biomechanical causes of post-operative gait adaptations such as 'quadriceps avoidance' observed in TKA patients., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The aims of this study were to evaluate and explain the individual muscle contributions to the medial and lateral knee compartment forces during gait, and to determine whether these quantities could be inferred from their contributions to the external knee adduction moment. Gait data from eight healthy male subjects were used to compute each individual muscle contribution to the external knee adduction moment, the net tibiofemoral joint reaction force, and reaction moment. The individual muscle contributions to the medial and lateral compartment forces were then found using a least-squares approach. While knee-spanning muscles were the primary contributors, non-knee-spanning muscles (e.g., the gluteus medius) also contributed substantially to the medial compartment compressive force. Furthermore, knee-spanning muscles tended to compress both compartments, while most non-knee-spanning muscles tended to compress the medial compartment but unload the lateral compartment. Muscle contributions to the external knee adduction moment, particularly those from knee-spanning muscles, did not accurately reflect their tendencies to compress or unload the medial compartment. This finding may further explain why gait modifications may reduce the knee adduction moment without necessarily decreasing the medial compartment force., (Copyright © 2012 Orthopaedic Research Society.)

Two of the most common gait patterns in children with spastic diplegic cerebral palsy (CP) are termed 'crouch gait' and 'jump gait'. While outcomes of surgical interventions designed to improve functional mobility are generally positive, many children displaying these gait patterns show minimal or no improvement post-surgery. A poor response to treatment may be partially attributable to incorrect interpretations of muscle function. Computational techniques that assess muscle function may help address this issue, but before studying specific surgeries, the gait patterns themselves must be better understood. The aim of this study was to identify differences in lower-limb muscle function when comparing crouch, jump and able-bodied gait patterns by quantifying the potential of lower-limb muscles to accelerate the body's center of mass. A muscle's potential acceleration was defined as the acceleration induced by a unit of muscle force. Dynamic simulations of walking using musculoskeletal models were developed for eight children with crouch gait, ten with jump gait, and ten controls. There were significant differences (p<0.05) in muscle potential accelerations between crouch and able-bodied gait patterns, and between jump and able-bodied gait patterns, for most of the major muscles of the hip, knee, and ankle. One important outcome was the identification of the significantly reduced potential of gluteus medius to extend the hip in both crouch gait and jump gait. Potential acceleration analyses appear to be suitable for evaluating differences between common gait patterns and may also be applied to study the effects of surgical treatments. The results of such studies may lead to improved treatment outcomes for individuals with impaired mobility., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Hill-type muscle models are commonly used in musculoskeletal models to estimate muscle forces during human movement. However, the sensitivity of model predictions of muscle function to changes in muscle moment arms and muscle-tendon properties is not well understood. In the present study, a three-dimensional muscle-actuated model of the body was used to evaluate the sensitivity of the function of the major lower limb muscles in accelerating the whole-body center of mass during gait. Monte-Carlo analyses were used to quantify the effects of entire distributions of perturbations in the moment arms and architectural properties of muscles. In most cases, varying the moment arm and architectural properties of a muscle affected the torque generated by that muscle about the joint(s) it spanned as well as the torques generated by adjacent muscles. Muscle function was most sensitive to changes in tendon slack length and least sensitive to changes in muscle moment arm. However, the sensitivity of muscle function to changes in moment arms and architectural properties was highly muscle-specific; muscle function was most sensitive in the cases of gastrocnemius and rectus femoris and insensitive in the cases of hamstrings and the medial sub-region of gluteus maximus. The sensitivity of a muscle's function was influenced by the magnitude of the muscle's force as well as the operating region of the muscle on its force-length curve. These findings have implications for the development of subject-specific models of the human musculoskeletal system., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The aim of this study was to compare muscle-force estimates derived for human locomotion using three different methods commonly reported in the literature: static optimisation (SO), computed muscle control (CMC) and neuromusculoskeletal tracking (NMT). In contrast with SO, CMC and NMT calculate muscle forces dynamically by including muscle activation dynamics. Furthermore, NMT utilises a time-dependent performance criterion, wherein a single optimisation problem is solved over the entire time interval of the task. Each of these methods was used in conjunction with musculoskeletal modelling and experimental gait data to determine lower-limb muscle forces for self-selected speeds of walking and running. Correlation analyses were performed for each muscle to quantify differences between the various muscle-force solutions. The patterns of muscle loading predicted by the three methods were similar for both walking and running. The correlation coefficient between any two sets of muscle-force solutions ranged from 0.46 to 0.99 (p < 0.001 for all muscles). These results suggest that the robustness and efficiency of static optimisation make it the most attractive method for estimating muscle forces in human locomotion.

Computational analyses of leg-muscle function in human locomotion commonly assume that contact between the foot and the ground occurs at discrete points on the sole of the foot. Kinematic constraints acting at these contact points restrict the motion of the foot and, therefore, alter model calculations of muscle function. The aim of this study was to evaluate how predictions of muscle function obtained from musculoskeletal models are influenced by the model used to simulate ground contact. Both single- and multiple-point contact models were evaluated. Muscle function during walking and running was determined by quantifying the contributions of individual muscles to the vertical, fore-aft and mediolateral components of the ground reaction force (GRF). The results showed that two factors--the number of foot-ground contact points assumed in the model and the type of kinematic constraint enforced at each point--affect the model predictions of muscle coordination. Whereas single- and multiple-point contact models produced similar predictions of muscle function in the sagittal plane, inconsistent results were obtained in the mediolateral direction. Kinematic constraints applied in the sagittal plane altered the model predictions of muscle contributions to the vertical and fore-aft GRFs, while constraints applied in the frontal plane altered the calculations of muscle contributions to the mediolateral GRF. The results illustrate the sensitivity of calculations of muscle coordination to the model used to simulate foot-ground contact.

Musculoskeletal computer models are often used to study muscle function in children with and without impaired mobility. Calculations of muscle forces depend in part on the assumed strength of each muscle, represented by the peak isometric force parameter, which is usually based on measurements obtained from cadavers of adult donors. The aim of the present study was twofold: first, to develop a method for scaling lower-limb peak isometric muscle forces in typically-developing children; and second, to determine the effect of this scaling method on model calculations of muscle forces obtained for normal gait. Muscle volumes were determined from magnetic resonance (MR) images obtained from ten children aged from 7 to 13yr. A new mass-length scaling law was developed based on the assumption that muscle volume and body mass are linearly related, which was confirmed by the obtained volume and body mass data. Two musculoskeletal models were developed for each subject: one in which peak isometric muscle forces were estimated using the mass-length scaling law; and another in which these parameters were determined directly from the MR-derived muscle volumes. Musculoskeletal modeling and quantitative gait analysis were then used to calculate lower-limb muscle forces in normal walking. The patterns of muscle forces predicted by the model with scaled peak isometric force values were similar to those predicted by the MR-based model, implying that assessments of muscle function obtained from these two methods are practically equivalent. These results support the use of mass-length scaling in the development of subject-specific musculoskeletal models of children., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Patellar tendon adhesion is a complication from anterior cruciate ligament (ACL) reconstruction that may affect patellofemoral and tibiofemoral biomechanics. A computational model was used to investigate the changes in knee joint mechanics due to patellar tendon adhesion under normal physiological loading during gait. The calculations showed that patellar tendon adhesion up to the level of the anterior tibial plateau led to patellar infera, increased patellar flexion, and increased anterior tibial translation. These kinematic changes were associated with increased patellar contact force, a distal shift in peak patellar contact pressure, a posterior shift in peak tibial contact pressure, and increased peak tangential contact sliding distance over one gait cycle (i.e., contact slip). Postadhesion, patellar and tibial contact locations corresponded to regions of thinner cartilage. The predicted distal shift in patellar contact was in contrast to other patellar infera studies. Average patellar and tibial cartilage pressure did not change significantly following patellar tendon adhesion; however, peak medial tibial pressure increased. These results suggest that changes in peak tibial cartilage pressure, contact slip, and the migration of contact to regions of thinner cartilage are associated with patellar tendon adhesion and may be responsible for initiating patellofemoral pain and knee joint structural damage observed following ACL reconstruction., (Copyright © 2011 Orthopaedic Research Society.)

Biomechanical assessments of muscle function are often performed using a generic musculoskeletal model created from anatomical measurements obtained from cadavers. Understanding the validity of using generic models to study movement biomechanics is critical, especially when such models are applied to analyze the walking patterns of persons with impaired mobility. The aim of this study was to evaluate the accuracy of scaled-generic models in determining the moment arms and functional roles of the lower-limb muscles during gait. The functional role of a muscle was described by its potential to contribute to the acceleration of a joint or the acceleration of the whole-body center of mass. A muscle's potential acceleration was defined as the acceleration induced by a unit of muscle force. Dynamic simulations of walking were generated for four children with cerebral palsy and five age-matched controls. Each subject was represented by a scaled-generic model and a model developed from magnetic resonance (MR) imaging. Calculations obtained from the scaled-generic model of each subject were evaluated against those derived from the corresponding MR-based model. Substantial differences were found in the muscle moment arms computed using the two models. These differences propagated to calculations of muscle potential accelerations, but predictions of muscle function (i.e., the direction in which a muscle accelerated a joint or the center of mass and the magnitude of the muscle's potential acceleration relative to that of other muscles) were consistent between the two modeling techniques. Our findings suggest that scaled-generic models and image-based models yield similar assessments of muscle function in both normal and pathological gait., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The aim of this study was to describe and explain how individual muscles control mediolateral balance during normal walking. Biomechanical modeling and experimental gait data were used to quantify individual muscle contributions to the mediolateral acceleration of the center of mass during the stance phase. We tested the hypothesis that the hip, knee, and ankle extensors, which act primarily in the sagittal plane and contribute significantly to vertical support and forward progression, also accelerate the center of mass in the mediolateral direction. Kinematic, force plate, and muscle EMG data were recorded simultaneously for five healthy subjects who walked at their preferred speeds. The body was modeled as a 10-segment, 23 degree-of-freedom skeleton, actuated by 54 muscles. Joint moments obtained from inverse dynamics were decomposed into muscle forces by solving an optimization problem that minimized the sum of the squares of the muscle activations. Muscles contributed significantly to the mediolateral acceleration of the center of mass throughout stance. Muscles that generated both support and forward progression (vasti, soleus, and gastrocnemius) also accelerated the center of mass laterally, in concert with the hip adductors and the plantarflexor everters. Gravity accelerated the center of mass laterally for most of the stance phase. The hip abductors, anterior and posterior gluteus medius, and, to a much lesser extent, the plantarflexor inverters, actively controlled balance by accelerating the center of mass medially., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Musculoskeletal models are currently the primary means for estimating in vivo muscle and contact forces in the knee during gait. These models typically couple a dynamic skeletal model with individual muscle models but rarely include articular contact models due to their high computational cost. This study evaluates a novel method for predicting muscle and contact forces simultaneously in the knee during gait. The method utilizes a 12 degree-of-freedom knee model (femur, tibia, and patella) combining muscle, articular contact, and dynamic skeletal models. Eight static optimization problems were formulated using two cost functions (one based on muscle activations and one based on contact forces) and four constraints sets (each composed of different combinations of inverse dynamic loads). The estimated muscle and contact forces were evaluated using in vivo tibial contact force data collected from a patient with a force-measuring knee implant. When the eight optimization problems were solved with added constraints to match the in vivo contact force measurements, root-mean-square errors in predicted contact forces were less than 10 N. Furthermore, muscle and patellar contact forces predicted by the two cost functions became more similar as more inverse dynamic loads were used as constraints. When the contact force constraints were removed, estimated medial contact forces were similar and lateral contact forces lower in magnitude compared to measured contact forces, with estimated muscle forces being sensitive and estimated patellar contact forces relatively insensitive to the choice of cost function and constraint set. These results suggest that optimization problem formulation coupled with knee model complexity can significantly affect predicted muscle and contact forces in the knee during gait. Further research using a complete lower limb model is needed to assess the importance of this finding to the muscle and contact force estimation process., (Copyright (c) 2009 Elsevier Ltd. All rights reserved.)

Musculoskeletal modeling and optimization theory are often used to determine muscle forces in vivo. However, convincing quantitative evaluation of these predictions has been limited to date. The present study evaluated model predictions of knee muscle forces during walking using in vivo measurements of joint contact loading acquired from an instrumented implant. Joint motion, ground reaction force, and tibial contact force data were recorded simultaneously from a single subject walking at slow, normal, and fast speeds. The body was modeled as an 8-segment, 21-degree-of-freedom articulated linkage, actuated by 58 muscles. Joint moments obtained from inverse dynamics were decomposed into leg-muscle forces by solving an optimization problem that minimized the sum of the squares of the muscle activations. The predicted knee muscle forces were input into a 3D knee implant contact model to calculate tibial contact forces. Calculated and measured tibial contact forces were in good agreement for all three walking speeds. The average RMS errors for the medial, lateral, and total contact forces over the entire gait cycle and across all trials were 140 +/- 40 N, 115 +/- 32 N, and 183 +/- 45 N, respectively. Muscle coordination predicted by the model was also consistent with EMG measurements reported for normal walking. The combined experimental and modeling approach used in this study provides a quantitative framework for evaluating model predictions of muscle forces in human movement., ((c) 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)

Background: This study investigated the extent to which reference frame convention affects the interpretation of how gait modification alters the external knee adduction moment., Methods: Data were collected from a single male able-bodied subject performing three gait tasks: normal, toe out and medial thrust. The net external moment vector at the knee was expressed in five alternative reference frames: the femur anatomical frame, the proximal tibia anatomical frame, the distal tibia anatomical frame, the laboratory frame and a non-orthogonal knee joint coordinate system. For each reference frame, the knee adduction moment was taken as the component about the frame's anteroposterior axis., Findings: Gait modification and selected reference frame both influenced the calculated knee adduction moment. Furthermore, these two effects were interactive, with the magnitude of the changes in the knee adduction moment produced by toe out and medial thrust gait being highly dependent on selected reference frame., Interpretation: Choice of reference frame for calculating the external knee adduction moment is therefore an important consideration for studies investigating the relative effectiveness of interventions such as gait modification.

The aim of this study was twofold: first, to determine which muscles and ligaments resist the adduction moment at the knee during normal walking; and second, to describe and explain the contributions of muscles, ligaments, and the ground reaction force to medial and lateral compartment loading. Muscle forces, ground reaction forces, and joint motions obtained from a dynamic optimization solution for normal walking were used as input to a three-dimensional model of the lower limb. A static equilibrium problem was solved at each instant of the gait cycle to determine tibiofemoral joint loading at the knee. Medial compartment loading was determined mainly by the orientation of the ground reaction force. Because this force vector passed medial to the knee, it applied an adduction moment about the joint during stance. In contrast, all of the force transmitted by the lateral compartment was due to muscle and ligament action. The muscles that contributed most to support and forward propulsion during normal walking (quadriceps and gastrocnemius) also contributed most to knee stability in the frontal plane. The knee ligaments, particularly those of the posterior lateral corner, provided stability to the knee at certain periods of the stance phase, when activity of the important stabilizing muscles was low., (Copyright (c) 2006 Orthopaedic Research Society.)

Purpose: The purpose of this investigation was to determine whether an isolated change in either quadriceps or hamstrings muscle force (quadriceps avoidance and hamstrings facilitation, respectively) is sufficient to stabilize the ACL-deficient (ACLd) knee during gait., Methods: A three-dimensional model of the lower limb was used to calculate anterior tibial translation in the intact and ACLd knee during gait. The model was then used to predict the amount of quadriceps and hamstrings force needed to restore anterior tibial translation (ATT) in the ACLd knee to an intact or maximum allowable level., Results: It was possible to reduce ATT in the ACLd knee to the level calculated for the intact knee by increasing the magnitude of hamstrings force (a hamstrings facilitation pattern). Although this strategy decreased the knee extensor moment calculated for walking, the effect was much less than that obtained when quadriceps force was reduced. Reducing quadriceps force to restore normal ATT resulted in complete elimination of the knee extensor moment (a quadriceps avoidance pattern); however, this strategy was insufficient to restore ATT to the level calculated for the intact knee over portions of the gait cycle., Conclusion: The model simulations showed that increased hamstrings force was sufficient to stabilize the ACLd knee during gait. Reduced quadriceps force was insufficient to restore normal ATT for portions of the gait cycle.

Adequate knee flexion velocity at toe-off is important for achieving normal swing-phase knee flexion during gait. Consequently, insufficient knee flexion velocity at toe-off can contribute to stiff-knee gait, a movement abnormality in which swing-phase knee flexion is diminished. This work aims to identify the muscles that contribute to knee flexion velocity during double support in normal gait and the muscles that have the most potential to alter this velocity. This objective was achieved by perturbing the forces generated by individual muscles during double support in a forward dynamic simulation of normal gait and observing the effects of the perturbations on peak knee flexion velocity. Iliopsoas and gastrocnemius were identified as the muscles that contribute most to increasing knee flexion velocity during double support. Increased forces in vasti, rectus femoris, and soleus were found to decrease knee flexion velocity. Vasti, rectus femoris, gastrocnemius, and iliopsoas were all found to have large potentials to influence peak knee flexion velocity during double support. The results of this work indicate which muscles likely contribute to the diminished knee flexion velocity at toe-off observed in stiff-knee gait, and identify the treatment strategies that have the most potential to increase this velocity in persons with stiff-knee gait.

A three-dimensional dynamic simulation of walking was used together with induced position analysis to determine how kinematic conditions at toe-off and muscle forces following toe-off affect peak knee flexion during the swing phase of normal gait. The flexion velocity of the swing-limb knee at toe-off contributed 30 degrees to the peak knee flexion angle; this was larger than any contribution from an individual muscle or joint moment. Swing-limb muscles individually made large contributions to knee angle (i.e., as large as 22 degrees), but their actions tended to balance one another, so that the combined contribution from all swing-limb muscles was small (i.e., less than 3 degrees of flexion). The uniarticular muscles of the swing limb made contributions to knee flexion that were an order of magnitude larger than the biarticular muscles of the swing limb. The results of the induced position analysis make clear the importance of knee flexion velocity at toe-off relative to the effects of muscle forces exerted after toe-off in generating peak knee flexion angle. In addition to improving our understanding of normal gait, this study provides a basis for analyzing stiff-knee gait, a movement abnormality in which knee flexion in swing is diminished.

The purpose of this study was to predict and explain the pattern of shear force and ligament loading in the ACL-deficient knee during walking, and to compare these results to similar calculations for the healthy knee. Musculoskeletal modeling and computer simulation were combined to calculate ligament forces in the ACL-deficient knee during walking. Joint angles, ground-reaction forces, and the corresponding lower-extremity muscle forces obtained from a whole-body dynamic optimization simulation of walking were input into a second three-dimensional model of the lower extremity that represented the knee as a six degree-of-freedom spatial joint. Anterior tibial translation (ATT) increased throughout the stance phase of gait when the model ACL was removed. The medial collateral ligament (MCL) was the primary restraint to ATT in the ACL-deficient knee. Peak force in the MCL was three times greater in the ACL-deficient knee than in the ACL-intact knee; however, peak force sustained by the MCL in the ACL-deficient knee was limited by the magnitude of the total anterior shear force applied to the tibia. A decrease in anterior tibial shear force was brought about by a decrease in the patellar tendon angle resulting from the increase in ATT. These results suggest that while the MCL acts as the primary restraint to ATT in the ACL-deficient knee, changes in patellar tendon angle reduce total anterior shear force at the knee.

While simple models can be helpful in identifying basic features of muscle function, more complex models are needed to discern the functional roles of specific muscles in movement. In this paper, two very different models of walking, one simple and one complex, are used to study how muscle forces, gravitational forces and centrifugal forces (i.e. forces arising from motion of the joints) combine to produce the pattern of force exerted on the ground. Both the simple model and the complex one predict that muscles contribute significantly to the ground force pattern generated in walking; indeed, both models show that muscle action is responsible for the appearance of the two peaks in the vertical force. The simple model, an inverted double pendulum, suggests further that the first and second peaks are due to net extensor muscle moments exerted about the knee and ankle, respectively. Analyses based on a much more complex, muscle-actuated simulation of walking are in general agreement with these results; however, the more detailed model also reveals that both the hip extensor and hip abductor muscles contribute significantly to vertical motion of the centre of mass, and therefore to the appearance of the first peak in the vertical ground force, in early single-leg stance. This discrepancy in the model predictions is most probably explained by the difference in model complexity. First, movements of the upper body in the sagittal plane are not represented properly in the double-pendulum model, which may explain the anomalous result obtained for the contribution of a hip-extensor torque to the vertical ground force. Second, the double-pendulum model incorporates only three of the six major elements of walking, whereas the complex model is fully 3D and incorporates all six gait determinants. In particular, pelvic list occurs primarily in the frontal plane, so there is the potential for this mechanism to contribute significantly to the vertical ground force, especially during early single-leg stance when the hip abductors are activated with considerable force.

The purpose of this study was to quantify the contributions made by individual muscles to support of the whole body during normal gait. A muscle's contribution to support was described by its contribution to the time history of the vertical force exerted by the ground. The analysis was based on a three-dimensional, muscle-actuated model of the body and a dynamic optimization solution for normal walking. The results showed that, in early stance, before the foot was placed flat on the ground, support was provided mainly by the ankle dorsiflexors. After foot-flat, but before contralateral toe-off, support was generated primarily by gluteus maximus, vasti, and posterior gluteus medius/minimus; these muscles were responsible for the first peak seen in the vertical ground-reaction force. The majority of support in midstance was provided by gluteus medius/minimus, with gravity assisting significantly as well. The ankle plantarflexors generated nearly all support in late stance; these muscles were responsible for the second peak in the vertical ground-reaction force. The results showed also that centrifugal forces act to decrease the vertical ground-reaction force, but only by minor amounts, and that resistance of the skeleton to the force of gravity is no larger than 1/2 body weight throughout the gait cycle.

ABSTRACT: This study quantified the contributions by muscular, gravitational and inertial forces to the ground reaction force (GRF) and external knee adduction moment (EKAM) for knee osteoarthritis (OA) patients and controls walking at similar speeds. Gait data for 39 varus mal‐aligned medial knee OA patients and 15 controls were input into musculoskeletal models to calculate the contributions of individual muscles and gravity to the fore‐aft (progression), vertical (support), and mediolateral (balance) GRF, and the EKAM. The temporal patterns of contributions to GRF and EKAM were similar between the groups. Magnitude differences in GRF contributions were small but some reached significance. Peak GRF contributions were lower in patients except hamstrings in early‐stance progression (p < 0.001) and gastrocnemius in late‐stance progression (p < 0.001). Both EKAM peaks were higher in patients, due mainly to greater adduction contribution from gravity (p < 0.001) at the first peak, and lower abduction contributions from soleus (p < 0.001) and gastrocnemius (p < 0.001) at the second peak. Gluteus medius contributed most to EKAM in both groups, but was higher in patients during mid‐stance only (p < 0.001). Differences in GRF contributions were attributed to altered quadriceps‐hamstrings action as well as compensatory adaptation of the ankle plantarflexors to reduced gluteus medius action. The large effect of varus mal‐alignment on the frontal‐plane moment arms of the gravity, soleus, and gastrocnemius GRF contributions about the knee explained greater patient EKAM. Our results shed further light on how the EKAM contributes to altered knee‐joint loads in OA and why some interventions may affect different portions of the EKAM waveform. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2157–2166, 2018. [ABSTRACT FROM AUTHOR]

ABSTRACT No data are available to describe six-degree-of-freedom (6-DOF) knee-joint kinematics for one complete cycle of overground walking following total knee arthroplasty (TKA). The aims of this study were firstly, to measure 6-DOF knee-joint kinematics and condylar motion for overground walking following TKA; and secondly, to determine whether such data differed between overground and treadmill gait when participants walked at the same speed during both tasks. A unique mobile biplane X-ray imaging system enabled accurate measurement of 6-DOF TKA knee kinematics during overground walking by simultaneously tracking and imaging the joint. The largest rotations occurred for flexion-extension and internal-external rotation whereas the largest translations were associated with joint distraction and anterior-posterior drawer. Strong associations were found between flexion-extension and adduction-abduction ( R2 = 0.92), joint distraction ( R2 = 1.00), and anterior-posterior translation ( R2 = 0.77), providing evidence of kinematic coupling in the TKA knee. Although the measured kinematic profiles for overground walking were grossly similar to those for treadmill walking, several statistically significant differences were observed between the two conditions with respect to temporo-spatial parameters, 6-DOF knee-joint kinematics, and condylar contact locations and sliding. Thus, caution is advised when making recommendations regarding knee implant performance based on treadmill-measured knee-joint kinematic data. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1634-1643, 2017. [ABSTRACT FROM AUTHOR]

The aim of this study was to perform full-body three-dimensional (3D) dynamic optimization simulations of human locomotion by driving a neuromusculoskeletal model toward in vivo measurements of body-segmental kinematics and ground reaction forces. Gait data were recorded from 5 healthy participants who walked at their preferred speeds and ran at 2 m/s. Participant-specific data-tracking dynamic optimization solutions were generated for one stride cycle using direct collocation in tandem with an OpenSim-MATLAB interface. The body was represented as a 12-segment, 21-degree-of-freedom skeleton actuated by 66 muscle-tendon units. Foot-ground interaction was simulated using six contact spheres under each foot. The dynamic optimization problem was to find the set of muscle excitations needed to reproduce 3D measurements of body-segmental motions and ground reaction forces while minimizing the time integral of muscle activations squared. Direct collocation took on average 2.7 ± 1.0 h and 2.2 ± 1.6 h of CPU time, respectively, to solve the optimization problems for walking and running. Model-computed kinematics and foot-ground forces were in good agreement with corresponding experimental data while the calculated muscle excitation patterns were consistent with measured EMG activity. The results demonstrate the feasibility of implementing direct collocation on a detailed neuromusculoskeletal model with foot-ground contact to accurately and efficiently generate 3D data-tracking dynamic optimization simulations of human locomotion. The proposed method offers a viable tool for creating feasible initial guesses needed to perform predictive simulations of movement using dynamic optimization theory. The source code for implementing the model and computational algorithm may be downloaded at http://simtk.org/home/datatracking . [ABSTRACT FROM AUTHOR]

The interaction between the muscle fascicle and tendon components of the human soleus (SO) muscle influences the capacity of the muscle to generate force and mechanical work during walking and running. In the present study, ultrasound-based measurements of in vivo SO muscle fascicle behavior were combined with an inverse dynamics analysis to investigate the interaction between the muscle fascicle and tendon components over a broad range of steady-state walking and running speeds: slow-paced walking (0.7 m/s) through to moderate-paced running (5.0 m/s). Irrespective of a change in locomotion mode (i.e., walking vs. running) or an increase in steady-state speed, SO muscle fascicles were found to exhibit minimal shortening compared with the muscle-tendon unit (MTU) throughout stance. During walking and running, the muscle fascicles contributed only 35 and 20% of the overall MTU length change and shortening velocity, respectively. Greater levels of muscle activity resulted in increasingly shorter SO muscle fascicles as locomotion speed increased, both of which facilitated greater tendon stretch and recoil. Thus the elastic tendon contributed the majority of the MTU length change during walking and running. When transitioning from walking to running near the preferred transition speed (2.0 m/s), greater, more economical ankle torque development is likely explained by the SO muscle fascicles shortening more slowly and operating on a more favorable portion (i.e., closer to the plateau) of the force-length curve. [ABSTRACT FROM AUTHOR]

Quantification of lower limb muscle function during gait or other common activities may be achieved using an induced acceleration analysis, which determines the contributions of individual muscles to the accelerations of the body's centre of mass. However, this analysis is reliant on a mathematical optimisation for the distribution of net joint moments among muscles. One approach that overcomes this limitation is the calculation of a muscle'spotentialto accelerate the centre of mass based on either a unit-force or maximum-activation assumption. Unit-force muscle potential accelerations are determined by calculating the accelerations induced by a 1 N muscle force, whereas maximum-activation muscle potential accelerations are determined by calculating the accelerations induced by a maximally activated muscle. The aim of this study was to describe the acceleration potentials of major lower limb muscles during normal walking obtained from these two techniques, and to evaluate the results relative to absolute (optimisation-based) muscle-induced accelerations. Dynamic simulations of walking were generated for 10 able-bodied children using musculoskeletal models, and potential- and absolute induced accelerations were calculated using a perturbation method. While the potential accelerations often correctly identified the major contributors to centre-of-mass acceleration, they were noticeably different in magnitude and timing from the absolute induced accelerations. Potential induced accelerations predicted by the maximum-activation technique, which accounts for the force-generating properties of muscle, were no more consistent with absolute induced accelerations than unit-force potential accelerations. The techniques described may assist treatment decisions through quantitative analyses of common gait abnormalities and/or clinical interventions. [ABSTRACT FROM AUTHOR]

When a muscle is activated, it contracts, develops force, and, by virtue of a lever arm, exerts a torque about one or more of the joints it spans. Dynamic coupling in a multi-joint system ensures that a muscle can simultaneously accelerate all the joints in the body, even those it does not span. The overall goal of the present study was to develop an accurate and computationally efficient method for quantifying muscle function during human locomotion. Our specific aims were first to assess the accuracy of the method by comparing its results against reference data reported in the literature; and second to demonstrate the application of the method in the study of leg-muscle function in walking and running. The method is based on using a pseudo-inverse to decompose the ground reaction force, enabling each muscle's contribution to the acceleration of any point on the body to be found at each instant of the gait cycle. One of the most appealing features of the pseudo-inverse method is that it can be applied either to data generated from a computer simulation or to measurements obtained from a gait experiment. The pseudo-inverse method is also roughly three orders of magnitude faster than an alternative approach based on perturbation analysis, which is commonly used to assess muscle function in human gait. The results show that the pseudo-inverse method is able to accurately reproduce reference data reported for normal walking. Predictions of leg-muscle function in walking and running are also consistent with findings reported previously by others. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to determine the sensitivity of muscle force estimates to changes in some of the parameters which are commonly used to describe models of muscle–tendon actuation. The sensitivity analysis was performed on three parameters: optimal muscle-fiber length, muscle physiological cross-sectional area (PCSA), and tendon rest length. The muscles selected for the analysis were posterior gluteus medius/minimus, vasti, soleus, and sartorius. Each parameter was perturbed from its nominal value, and an optimization problem was solved to determine the relative influence of each parameter on the calculated values of muscle force. Muscle forces were calculated for a simulated cycle of normal walking. Parameter sensitivity was quantified using two new metrics: an integrated sensitivity ratio, which quantified the effect of changing a single parameter for any muscle on the time history of force developed by that muscle; and a summed cross-sensitivity ratio, which quantified the effect of changing one parameter for any muscle on the time histories of forces developed by all of the other muscles. The results showed that muscle force estimates for walking are most sensitive to changes in tendon rest length and least sensitive to changes in muscle PCSA. For soleus, for example, the integrated sensitivity ratios for tendon rest length were an order of magnitude greater than those for muscle-fiber length and PCSA. For vasti, the integrated sensitivity ratios for tendon rest length were twice as large as those for muscle-fiber length and nearly an order of magnitude greater than those for PCSA. Overall, changes in the tendon rest lengths of vasti and soleus and changes in the fiber length of vasti were most critical to model estimates of muscle force. Our results emphasize the importance of obtaining accurate estimates of tendon rest length and muscle-fiber length, particularly for those actuators that function as prime movers during locomotion (gluteus maximus, gluteus medius/minimus, vasti, soleus, and gastrocnemius). [Copyright &y& Elsevier]

Abstract: Crouch gait, a troublesome movement abnormality among persons with cerebral palsy, is characterized by excessive flexion of the hips and knees during stance. Treatment of crouch gait is challenging, at present, because the factors that contribute to hip and knee extension during normal gait are not well understood, and because the potential of individual muscles to produce flexion or extension of the joints during stance is unknown. This study analyzed a three-dimensional, muscle-actuated dynamic simulation of walking to quantify the angular accelerations of the hip and knee induced by muscles during normal gait, and to rank the potential of the muscles to alter motions of these joints. Examination of the muscle actions during single limb stance showed that the gluteus maximus, vasti, and soleus make substantial contributions to hip and knee extension during normal gait. Per unit force, the gluteus maximus had greater potential than the vasti to accelerate the knee toward extension. These data suggest that weak hip extensors, knee extensors, or ankle plantar flexors may contribute to crouch gait, and strengthening these muscles—particularly gluteus maximus—may improve hip and knee extension. Abnormal forces generated by the iliopsoas or adductors may also contribute to crouch gait, as our analysis showed that these muscles have the potential to accelerate the hip and knee toward flexion. This work emphasizes the need to consider how muscular forces contribute to multijoint movements when attempting to identify the causes of abnormal gait. [Copyright &y& Elsevier]

Background: The effect of tibiofemoral geometry on musculoskeletal function is important to movement biomechanics.Research Question: We hypothesised that tibiofemoral geometry determines tibiofemoral motion and musculoskeletal function. We then aimed at 1) modelling tibiofemoral motion during normal activity as a function of tibiofemoral geometry in healthy adults; and 2) quantifying the effect of tibiofemoral geometry on musculoskeletal function.Methods: We used motion data for six activity types and CT images of the knee from 12 healthy adults. Geometrical variation of the tibia and femoral articular surfaces were measured in the CT images. The geometry-based tibiofemoral motion was calculated by fitting a parallel mechanism to geometrical variation in the cohort. Matched musculoskeletal models embedding the geometry-based tibiofemoral joint motion and a common generic tibiofemoral motion of reference were generated and used to calculate joint angles, net joint moments, muscle and joint forces for the six activities analysed. The tibiofemoral model was validated against bi-planar fluoroscopy measurements for walking for all the six planes of motion. The effect of tibiofemoral geometry on musculoskeletal function was the difference between the geometry-based model and the model of reference.Results: The geometry-based tibiofemoral motion described the pattern and the variation during walking for all six motion components, except the pattern of anterior tibial translation. Tibiofemoral geometry had moderate effect on cohort-averages of musculoskeletal function (R2 = 0.60-1), although its effect was high in specific instances of the model, outputs and activities analysed, reaching 2.94 BW for the ankle reaction force during stair descent. In conclusion, tibiofemoral geometry is a major determinant of tibiofemoral motion during walking.Significance: Geometrical variations of the tibiofemoral joint are important for studying musculoskeletal function during normal activity in specific individuals but not for studying cohort averages of musculoskeletal function. This finding expands current knowledge of movement biomechanics. [ABSTRACT FROM AUTHOR]

Various methods are available for simulating the movement patterns of musculoskeletal systems and determining individual muscle forces, but the results obtained from these methods have not been rigorously validated against experiment. The aim of this study was to compare model predictions of muscle force derived for a cat hindlimb during locomotion against direct measurements of muscle force obtained in vivo. The cat hindlimb was represented as a 5-segment, 13-degrees-of-freedom (DOF), articulated linkage actuated by 25 Hill-type muscle-tendon units (MTUs). Individual muscle forces were determined by combining gait data with two widely used computational methods--static optimization and computed muscle control (CMC)--available in opensim, an open-source musculoskeletal modeling and simulation environment. The forces developed by the soleus, medial gastrocnemius (MG), and tibialis anterior muscles during free locomotion were measured using buckle transducers attached to the tendons. Muscle electromyographic activity and MTU length changes were also measured and compared against the corresponding data predicted by the model. Model-predicted muscle forces, activation levels, and MTU length changes were consistent with the corresponding quantities obtained from experiment. The calculated values of muscle force obtained from static optimization agreed more closely with experiment than those derived from CMC. [ABSTRACT FROM AUTHOR]