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Biomechanical changes after anterior cruciate ligament reconstruction (ACLR) may be detrimental to long-term knee-joint health. We used pattern recognition to characterise biomechanical differences during the landing phase of a single-leg forward hop after ACLR. Experimental data from 66 individuals 12-24 months post-ACLR (28.2 ± 6.3 years) and 32 controls (25.2 ± 4.8 years old) were input into a musculoskeletal modelling pipeline to calculate joint angles, joint moments and muscle forces. These waveforms were transformed into principal components (features), and input into a pattern recognition pipeline, which found 10 main distinguishing features (and 8 associated features) between ACLR and control landing biomechanics at significance $$\alpha =0.05$$ α = 0.05 . Our process identified known biomechanical characteristics post-ACLR: smaller knee flexion angle; less knee extensor moment; lower vasti, rectus femoris and hamstrings forces. Importantly, we found more novel and less well-understood adaptations: smaller ankle plantar flexor moment; lower soleus forces; and altered patterns of knee rotation angle, hip rotator moment and knee abduction moment. Crucially, we identified, with high certainty, subtle aberrations indicating landing instability in the ACLR group for: knee flexion and internal rotation angles and moments; hip rotation angles and moments; and lumbar rotator and bending moments. Our findings may benefit rehabilitation and assessment for return-to-sport 12–24 months post-ACLR.

Background Biomechanical analyses primarily focus on physical aspects of human movement; however, it is not understood how walking is affected while simultaneously performing a demanding cognitive task - a form of Cognitive-Motor Interference (CMI). CMI occurs when performance of a primary task (e.g. walking) is affected following the introduction of a cognitive task (e.g. visual search). Research question Would Visuo Motor Targeting Task (VMTT) impair visual search performance and reduce the margin of stability (MoS) at higher gait speeds? Methods A protocol was developed to investigate responses of the neuromuscular system while performing a complex visual search task. The Computer Assisted Rehabilitation ENvironment (CAREN, Motekforce Link, Netherlands) system was used for the experimental design. Twenty male participants (Age = 24.2 ± 2.5yrs, Weight = 70.3 ± 10.6 kg, Height = 178.0 ± 9.1 cm) located and pointed towards targets in complex scenes while walking at different gait speeds (0.55, 1.11 and 1.67 m/s.) or while stationary. The cost of visual search during a Visuo Motor Targeting Task (VMTT) was based on the pointing accuracy during the visual search task. Results A two-way repeated measure ANOVA showed that MoS in the ML direction significantly improved with increased gait speed and during the visual search task. There was also a significant interaction with MoS improvement being greater during the visual search task at high gait speeds. MoS in the AP was only affected by gait speed. Visual performance and cost of visual search were enhanced during walking versus standing up to 25 %. Significance This study investigated CMI at different gait speeds, which may have implications in postural control, falls and other neurological disorders.

Vertebral fractures (VFx) are common among older adults. Epidemiological studies report high occurrence of VFx at mid-thoracic and thoracolumbar regions of the spine; however, reasons for this observation remain poorly understood. Prior reports of high ratios of spinal loading to vertebral strength in the thoracolumbar region suggest a possible biomechanical explanation. However, no studies have evaluated load-to-strength ratios (LSRs) throughout the spine for a large number of activities in a sizeable cohort. Thus, we performed a cross-sectional study in a sample of adult men and women from a population-based cohort to: 1) determine which activities cause the largest vertebral LSRs, and 2) examine patterns of LSRs along the spine for these high-load activities. We used subject-specific musculoskeletal models of the trunk to determine vertebral compressive loads for 109 activities in 250 individuals (aged 41 to 90 years, 50% women) from the Framingham Heart Study. Vertebral compressive strengths from T4 to L4 were calculated from computed tomography-based vertebral size and bone density measurements. We determined which activities caused maximum LSRs at each of these spinal levels. We identified nine activities that accounted for >95% of the maximum LSRs overall and at least 89.6% at each spinal level. The activity with the highest LSR varied by spinal level, and three distinct spinal regions could be identified by the activity producing maximum LSRs: lateral bending with a weight in one hand (upper thoracic), holding weights with elbows flexed (lower thoracic), and forward flexion with weight (lumbar). This study highlights the need to consider a range of lifting, holding, and non-symmetric activities when evaluating vertebral LSRs. Moreover, we identified key activities that produce higher loading in multiple regions of the spine. These results provide the first guidance on what activities to consider when evaluating vertebral load-to-strength ratios in future studies, including those examining dynamic motions and the biomechanics of VFx. © 2020 American Society for Bone and Mineral Research (ASBMR).

We aim to demystify the development of neuro-biomechanical modeling in OpenSim with zero configuration, easy to share models while accessing to free GPUs on a web-based platform of Google Colaboratory. OpenSim is an open-source biomechanical package. OpenSim is used in a variety of applications and developed in C++; however, it is available for a wide range of users with bindings in MATLAB, Python, Jython and Java via OpenSim Application Programing Interface (API). OpenSim installation on a personal computer is well described by the developers but its implementation may still be time-consuming and challenging for the new users. Cloud-based computing is expanding in almost all engineering domains with zero configuration, though it is in its early stages within biomechanics community. In this study, we aim to access OpenSim functionality on the Google cloud platform. The methods can also be used in other cloud-based platforms. We installed OpenSim on the Google Colab via Anaconda cloud and named it OpenColab. To use OpenColab, one requires only a connection to the internet and a Gmail account. Moreover, such a platform enables the users to access vast libraries of machine learning available within free Google products e.g., TensorFlow. OpenColab takes advantage of zero configuration of cloud-based platforms even on a smart phone, provides access to free GPUs and enables users to share and reproduce modeling approaches for further validation. Finally, we performed inverse problem in biomechanics and compared OpenColab results with OpenSim GUI’s for validation. Step-by-step installation processes and examples can be found freely at: https://simtk.org/projects/opencolab.

Female athletes are more prone to anterior cruciate ligament (ACL) injury. A neuromuscular imbalance called leg dominance may provide a biomechanical explanation. Therefore, the purpose of this study was to compare the side-to-side lower limb differences in movement patterns, muscle forces and ACL forces during a single-leg drop-landing task from two different heights. We hypothesized that there will be significant differences in lower limb movement patterns (kinematics), muscle forces and ACL loading between the dominant and non-dominant limbs. Further, we hypothesized that significant differences between limbs will be present when participants land from a greater drop-landing height. Eight recreational female participants performed dominant and non-dominant single-leg drop landings from 30 to 60cm. OpenSim software was used to develop participant-specific musculoskeletal models and to calculate muscle forces. We also predicted ACL loading using our previously established method. There were no significant differences between dominant and non-dominant leg landing except in ankle dorsiflexion and GMED muscle forces at peak GRF. Landing from a greater height resulted in significant differences among most kinetics and kinematics variables and ACL forces. Minimal differences in lower-limb muscle forces and ACL loading between the dominant and non-dominant legs during single-leg landing may suggest similar risk of injury across limbs in this cohort. Further research is required to confirm whether limb dominance may play an important role in the higher incidence of ACL injury in female athletes with larger and sport-specific cohorts.

We created subject-specific musculoskeletal models of the thoracolumbar spine by incorporating spine curvature and muscle morphology measurements from computed tomography (CT) scans to determine the degree to which vertebral compressive and shear loading estimates are sensitive to variations in trunk anatomy. We measured spine curvature and trunk muscle morphology using spine CT scans of 125 men, and then created four different thoracolumbar spine models for each person: (i) height and weight adjusted (Ht/Wt models); (ii) height, weight, and spine curvature adjusted (+C models); (iii) height, weight, and muscle morphology adjusted (+M models); and (iv) height, weight, spine curvature, and muscle morphology adjusted (+CM models). We determined vertebral compressive and shear loading at three regions of the spine (T8, T12, and L3) for four different activities. Vertebral compressive loads predicted by the subject-specific CT-based musculoskeletal models were between 54% lower to 45% higher from those estimated using musculoskeletal models adjusted only for subject height and weight. The impact of subject-specific information on vertebral loading estimates varied with the activity and spinal region. Vertebral loading estimates were more sensitive to incorporation of subject-specific spinal curvature than subject-specific muscle morphology. Our results indicate that individual variations in spine curvature and trunk muscle morphology can have a major impact on estimated vertebral compressive and shear loads, and thus should be accounted for when estimating subject-specific vertebral loading. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2164-2173, 2017.

Knee injuries are common during landing activities. Greater landing height increases peak ground reaction forces (GRFs) and loading at the knee joint. As major muscles to stabilize the knee joint, Quadriceps and Hamstring muscles provide internal forces to attenuate the excessive GRF. Despite the number of investigations on the importance of muscle function during landing, the role of landing height on these muscles forces using modeling during landing is not fully investigated.Participant-specific musculoskeletal models were developed using experimental motion analysis data consisting of anatomic joint motions and GRF from eight male participants performing double-leg drop landing from 30 and 60 cm. Muscle forces were calculated in OpenSim and their differences were analyzed at the instances of high risk during landing i.e. peak GRF for both heights.The maximum knee flexion angle and moments were found significantly higher from a double-leg landing at 60 cm compared to 30 cm. The results showed elevated GRF, and mean muscle forces during landing. At peak GRF, only quadriceps showed significantly greater forces at 60 cm. Hamstring muscle forces did not significantly change at 60 cm compared to 30 cm.Quadriceps and hamstring muscle forces changed at different heights. Since hamstring forces were similar in both landing heights, this could lead to an imbalance between the antagonist muscles, potentially placing the knee at risk of injury if combined with small flexion angles that was not observed at peak GRF in our study. Thus, enhanced neuromuscular training programs strengthening the hamstrings may be required to address this imbalance. These findings may contribute to enhance neuromuscular training programs to prevent knee injuries during landing.

Copyright © 2017 Saulo Martelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD) in the exercise leg were adjusted for changes in the control leg. The biomechanical stimulus for bone adaptation (BS) was calculated using published models of the musculoskeletal system and the average hip extension moment in elderly participants. Volumetric (ΔvBMD) and areal (ΔaBMD) BMD changes were calculated. The measured and calculated BMD changes consistently showed a positive and negative effect of exercise in the femoral neck (ΔaBMD = +0.7%; ΔvBMD = +0.8%) and the trochanter region (ΔaBMD = −4.1%; ΔvBMD = −0.5%), respectively. The 17% of the femoral neck exceeded the 75th percentile of the spatially heterogeneous BS distribution. Hip extensor exercises may be beneficial in the proximal femoral neck but not in the trochanteric region. DXA-based measurements may not capture significant aBMD local changes.

The aim of this study was to identify the contribution of the Soleus and Gastrocnemius (Gastroc) muscles' forces to anterior cruciate ligament (ACL) loading during single-leg landing. Although Quadriceps (Quads) and Hamstrings (Hams) muscles were recognized as the main contributors to the ACL loading, less is known regarding the role of ankle joint plantarflexors during landing. Eight healthy subjects performed single-landing tasks from 30 and 60cm heights. Scaled generic musculoskeletal models were developed in OpenSim to calculate lower limb muscle forces. The model consisted of 10 segments with 23 degrees of freedom and 92 lower body muscle-tendon units. Knee joint reaction forces were calculated based on the estimated muscle forces and used to predict ACL forces. We hypothesized that Soleus and Gastrocs muscle forces have opposite effects on tibial loading in the anterior/posterior directions. In situations where greater landing height would lead to an increase in GRF and risk of ACL injury, we further hypothesized that posterior forces of the Soleus and Hams would increase correspondingly to help protect the ACL during a safe landing maneuver. Our results demonstrated the antagonistic and agonistic roles of Gastrocs and Soleus respectively in ACL loading. The posterior force of Soleus reached 28-32% of Ham's posterior force for both landing heights at peak GRF while the posterior force of Gastrocs on femur was negligible. ACL injury risk during single-leg landing is not only dependent on knee musculature but also influenced by muscles that do not span the knee joint, such as the Soleus. In conclusion, the role of the ankle plantarflexors should be considered when developing training strategies for ACL injury prevention.

We created subject-specific musculoskeletal models of the thoracolumbar spine by incorporating spine curvature and muscle morphology measurements from computed tomography (CT) scans to determine the degree to which vertebral compressive and shear loading estimates are sensitive to variations in trunk anatomy. We measured spine curvature and trunk muscle morphology using spine CT scans of 125 men, and then created four different thoracolumbar spine models for each person: (i) height and weight adjusted (Ht/Wt models); (ii) height, weight, and spine curvature adjusted (+C models); (iii) height, weight, and muscle morphology adjusted (+M models); and (iv) height, weight, spine curvature, and muscle morphology adjusted (+CM models). We determined vertebral compressive and shear loading at three regions of the spine (T8, T12, and L3) for four different activities. Vertebral compressive loads predicted by the subject-specific CT-based musculoskeletal models were between 54% lower to 45% higher from those estimated using musculoskeletal models adjusted only for subject height and weight. The impact of subject-specific information on vertebral loading estimates varied with the activity and spinal region. Vertebral loading estimates were more sensitive to incorporation of subject-specific spinal curvature than subject-specific muscle morphology. Our results indicate that individual variations in spine curvature and trunk muscle morphology can have a major impact on estimated vertebral compressive and shear loads, and thus should be accounted for when estimating subject-specific vertebral loading. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2164-2173, 2017.

This review examines the current evidence for associations between vertebral fractures (VFx), the most common type of fracture in older adults, and trunk muscles, which are intimately tied to spinal loading and function. Individuals with prevalent VFxs have more fat infiltration in the trunk muscles, lower trunk extension strength, and altered muscle activation patterns. However, no longitudinal studies have examined whether assessment of trunk muscle can contribute to prediction of fracture risk. A few studies report that exercise interventions targeting the trunk muscles can reduce the risk of VFx, improve trunk strength and endurance in patients who have had a VFx, and reduce the risk of falling, a common cause of VFx, but the quality of evidence is low. Trunk muscles likely have an important role to play in prediction, prevention, and management of VFx, but additional longitudinal studies and randomized controlled trials are needed to clarify this role.

In this paper a complete design of a high speed optical motion analyzer system has been described. The main core of the image processing unit has been implemented by the differential algorithm procedure. Some intelligent and conservative procedures that facilitate the search algorithm have also been proposed and implemented for the processing of human motions. Moreover, an optimized modified direct linear transformation (MDLT) method has been used to reconstruct 3D markers positions which are used for deriving kinematic characteristics of the motion. Consequently, a set of complete tests using some simple mechanical devices were conducted to verify the system outputs. Considering the system verification for human motion analysis, we used the system for gait analysis and the results including joint angles showed good compatibility with other investigations. Furthermore, a sport application example of the system has been quantitatively presented and discussed for Iranian National Karate-kas. The low computational cost, the high precision in detecting and reconstructing marker position with 2.39 mm error, and the capability of capturing from any number of cameras to increase the domain of operation of the subject, has made the proposed method a reliable approach for real-time human motion analysis. No special environment limitation, portability, low cost hardware and built in units for simulations and kinematic analysis are the other significant specifications of this system.

The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error

Internal tibial rotation is a risk factor for anterior cruciate ligament (ACL) injury. The effect of restraining tibial rotation (RTR) to prevent ACL injury during single-leg landing is not well understood. We aimed to investigate the effect of impact load and RTR on ACL injury with respect to flexion angle. We hypothesized that RTR could protect the knee from ACL injury compared to free tibial rotation (FTR) regardless of flexion angle and create a safety zone to protect the ACL.Thirty porcine specimens were potted in a rig manufactured to replicate single-leg landing maneuvers. A mechanical testing machine was used to apply external forces in the direction of the tibial long axis. A 3D displacement sensor measured anterior tibial translation (ATT). The specimens were divided into 3 groups of 10 specimens and tested at flexion angles of 22 ± 1°, 37 ± 1° and 52 ± 1° (five RTR and five FTR) through a consecutive range of actuator displacements until ACL failure. After dissection, damage to the joint was visually recorded. Two-way ANOVA were utilized in order to compare compressive forces, torques and A/P displacements with respect to flexion angle.The largest difference between peak axial compressive forces (~3.4 kN) causing ACL injury between RTR and FTR was reported at a flexion angle of 22°. Tibial torques with RTR was in the same range and20 Nm at the instance and just before ACL failure, compared to a significant reduction when cartilage/bone damage (no ACL failure) was reported. Isolated ACL injuries were observed in ten of the 15 FTR specimens. Injuries to bone and cartilage were more common with RTR.RTR increases the threshold for ACL injury by elevating the compressive impact load required at lower flexion angles. These findings may contribute to neuromuscular training programs or brace designs used to avoid excessive internal/external tibial rotation. Caution must be exercised as bone/cartilage damage may result.

Prevalence of LBP has led researchers to find out biomechanics of lumbar spine in conjunction with the surrounding muscles and the role of intra-abdominal pressure in different activities. Despite substantial number of experimental studies in this field, limitations of in-vivo experiments have guided researchers to utilize mathematical modeling to obtain more information regarding the spine biomechanics. An important aspect of such spinal modeling is to replicate the muscle behavior which includes nonlinear mechanical properties. In this study, we developed a finite element model of the spine with the surrounding muscles consisting both active and passive behavior of the muscles at the same time. In order to have more realistic muscles, we used the combination of a 1-D nonlinear element and a 2-D linear elastic shell. The shell element can take initial stress, while the 1-D element can take force-displacement relationship. For each muscle, 1-D elements were laid on shell elements in the direction of muscle fibers. In a specific activity level, initial stress and stiffness of shell elements and force-displacement relation of 1-D elements were changed based on mathematical model of muscles published in the literature. The effects of two muscles of the model were investigated on lumbar spine and IAP. These muscles are rectus abdominis and transversus abdominis. Results show that TA has an important effect on IAP generation and this muscle can produce extensor moment due to increasing IAP. RA has flexor role and has no important effect on IAP. Also analyses have predicted a reduction in lumbar spine compression force with increasing IAP.

Jumping and subsequent landing was found to be one of the most injurious maneuvers to the anterior cruciate ligament (ACL). The ability to predict ACL susceptibility to injury is extremely difficult due to the complex interaction between the lower extremity joints and the surrounding musculoskeletal structure. While muscles play an important role, whether they act to prevent ACL injury during drop landing is still debatable. Our objective is to quantify and compare the muscles recruitment and actions for different drop landing methods, which include single and double leg landing. We hypothesized that: 1.) recruitment of antagonist muscles (Quadriceps force (Q) and Hamstrings force (H)) differs between the two different drop landing methods; 2.) a linear relationship exists between Q/H ratio and Ground Reaction Force (GRF), independent of drop landing height and landing methods. Lower extremity muscles’ force were calculated and compared. Vertical GRF was found to increase in single leg landing. GRF and Q/H ratio were inversely proportional at the time of peak GRF. We concluded that muscles’ force ratio around knee joint in conjunction with GRF and knee flexion angle are important parameters affecting the risk of ACL injury during drop landing.

In spite of earlier experimental and modeling studies, the relative role of the intra-abdominal pressure (IAP) in spine mechanics has remained controversial. This study employs simple analytical and finite element (FE) models of the spine and its surrounding structures to investigate the contribution of IAP to spinal loading and stability. The analytical model includes the abdominal cavity surrounded by muscles, lumbar spine, rib cage and pelvic ring. The intra-abdominal cavity and its surrounding muscles are represented by a thin deformable cylindrical membrane. Muscle activation levels are simulated by changing the Young's modulus of the membrane in the direction of muscle fibers, yielding IAP values recorded under the partial Valsalva maneuver. In the FE model, the abdominal cavity is cylindrical and filled with a nearly incompressible fluid. The surrounding muscles are modeled as membrane elements with transverse isotropic material properties simulating their fiber orientation. Results indicate a good qualitative agreement between the analytical and FE models. Larger external force and/or higher levels of muscle activation generate higher IAP thereby increasing spinal stiffness. These effects are more pronounced for activation of muscles with more horizontally directed fibers, e.g., transverse abdominis (TA). The capacity of the abdominal muscles to indirectly unload and stabilize the spine by generating IAP depends mostly on their fiber orientation, and secondarily on their cross-section area.

INTRODUCTION Low back pain is one of the most costly disorders that disturbs the productivity and well-being of affected population. The role and significance of the intra-abdominal pressure (IAP) in spine mechanics has remained controversial and only a few studies investigated the effects of IAP on spine stability. Hence, we developed an FE model in order to advance our previous model studies [1, 2]. The muscles are modeled as continuous fiber-reinforced membranes that surround the intra-abdominal cavity. These models also take advantage of beam elements representing the spine. Then an optimization program using APDL was performed to evaluate the muscles recruitment while considering IAP effect. Although our model is still idealized due to its anatomical details, it can predict IAP effect on the active spine.

In spite of the several experimental and modeling studies on the biomechanical characteristics of the human spine, the role and significance of the intra-abdominal pressure (IAP) in spine mechanics has remained controversial. This study represents a simple analytical and a 3-D finite element model of spine and its surrounding structures to investigate the contribution of IAP to spinal stability. The mathematical model included the lumbar spine column, the abdominal cavity and a muscular layer around it, the rib cage and the pelvic ring. The lumbar spine column was modeled as a beam and the rib cage and pelvis as rigid bodies. The intra-abdominal cavity and the surrounding muscular layer were represented by a thin-wall cylindrical vessel with deformable shell wall. The free body diagram and equilibrium equations of each body of the model were derived while an external load to the rib cage was applied. The equations were then combined with the force-deflection relationships for the beam bending, the IAP fluid volume variation, and the muscle shell traction. Muscle activation levels were simulated by changing the Young’s modulus of the shell in the direction of fibers, up to an upper-limit value which was obtained based on the Valsalva maneuver. In the Finite Element (FE) model, the abdominal cavity was assumed to be cylindrical and filled by fluid with a bulk modulus of IMPa. The surrounding muscular layer was modeled as membrane with transverse isotropic material properties considering their fibers orientation. The spine, rib cage and pelvic ring were modeled by beam elements. The top plate simulated the active and/or passive role of diaphragm through its vertical displacement. The bottom membrane and distal spine were fully constrained. Good agreement between the analytical and FE model results was obtained. A larger external force and/or higher level of muscle activation caused a higher IAP, improving spinal unloading and stability. This effect was more significant for muscles with more horizontally directed fibers, e.g., Transverse Abdominis (TA).Copyright © 2006 by ASME