Does your competent? doctor and hospital immediately see this as a way to get your objective gait problems identified and then use that to map to EXACT PROTOCOLS THAT DELIVER RECOVERY? NO? SO YOU DON'T HAVE A FUNCTIONING STROKE DOCTOR OR HOSPITAL? RUN AWAY!
Multibody dynamics-based musculoskeletal modeling for gait analysis: a systematic review
Journal of NeuroEngineering and Rehabilitation volume 21, Article number: 178 (2024)
Abstract
Beyond qualitative assessment, gait analysis involves the quantitative evaluation of various parameters such as joint kinematics, spatiotemporal metrics, external forces, and muscle activation patterns and forces. Utilizing multibody dynamics-based musculoskeletal (MSK) modeling provides a time and cost-effective non-invasive tool for the prediction of internal joint and muscle forces. Recent advancements in the development of biofidelic MSK models have facilitated their integration into clinical decision-making processes, including quantitative diagnostics, functional assessment of prosthesis and implants, and devising data-driven gait rehabilitation protocols. Through an extensive search and meta-analysis of over 116 studies, this PRISMA-based systematic review provides a comprehensive overview of different existing multibody MSK modeling platforms, including generic templates, methods for personalization to individual subjects, and the solutions used to address statically indeterminate problems. Additionally, it summarizes post-processing techniques and the practical applications of MSK modeling tools. In the field of biomechanics, MSK modeling provides an indispensable tool for simulating and understanding human movement dynamics. However, limitations which remain elusive include the absence of MSK modeling templates based on female anatomy underscores the need for further advancements in this area.
Introduction
Gait or human walking signatures have long been used to quantify underlying health conditions, ranging from neurological and musculoskeletal (MSK) conditions to cardiovascular and metabolic disease, and to ageing associated ambulatory dysfunction and trauma [1]. Conventionally, gait is analyzed using measured anthropometric, kinematic, external kinetic, and muscle activity parameters. With the advancement in computing power, solving complex equations has been made feasible leading to the development of multibody dynamic models and systems mimicking humans [2].
Several multibody systems have been used in MSK modeling to understand and simulate complex interactions within the human body and of the human body with the environment. These include Empirically-based Multibody Dynamics [3], fast ligament models [4], OpenSim [5], Combined Multibody Musculoskeletal Dynamic Modeling and Finite Element Modeling [6] and commercial multibody modeling MSK systems like the AnyBody Modeling System (AMS) [7], Human Body Model [8], Software for Interactive Musculoskeletal Modelling [9], and Biomechanics of Bodies [10]. These software packages play a crucial role in various applications, including biomechanical evaluation of healthy and impaired individuals.
Gait analysis coupled with MSK modeling emerges as a state-of-the-art approach to delve deeper into the biomechanical intricacies of gait. This comprehensive method integrates multimodal data from motion capture systems for kinematics; force plates or instrumented walking mats/treadmills for ground reaction forces and moments (GRFs/GRMs); and muscle activity from electromyography (EMG) systems. The multidimensional data is then fed into MSK modeling software, which uses a generic MSK model to calculate the intersegmental joint reaction forces (JRFs), joint reaction moments (JRMs), as well as muscle forces using either inverse or forward dynamic analysis.
The primary aim of this review is to provide a systematic literature overview of different existing multibody MSK modeling methodologies, and their applications for gait analysis. More specifically, the study summarizes experimental protocols and data required to run MSK simulations; describe the most commonly used MSK modeling templates; highlight the personalization of these generic templates to match subject anthropometrics; outline the commonly employed solvers i.e., inverse kinematics (IK), inverse dynamics (ID), and identify the muscle recruitment techniques to compute joint kinematics, kinetics, muscle forces, and external kinetics. Moreover, this article also describes post processing of gait data for event detection, and the importance of joint JRFs, JRMs, and muscle parameters, as well as relevant applications of MSK modeling. This review is organized as follows: Sect. 2 introduces the adopted methodology, including the search criteria and meta-analysis. Section 3 reviews the conventional parameters quantifying gait and significance of MSK modeling in gait analysis. Section 4 describes the most common kinematic, kinetic, and muscle activity measurement techniques used for model input data, while Sect. 5 elaborates on current state-of-the-art platforms used in MSK modeling. Sections 6 and 7 describe generic MSK modeling templates and their personalization techniques, respectively. Section 8 discusses solving formulations, including inverse kinematics, dynamics, and muscle recruitment. Section 9 highlights post processing of gait data, while Sect. 10 summarizes relevant applications.
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