Functional Evaluation of a Personalized Orthosis for Knee Osteoarthritis - A Motion Capture Analysis

2021 ◽  
Author(s):  
Martin Huber ◽  
Matthew Eschbach ◽  
Kazem Kazerounian ◽  
Horea T. Ilies
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Motion Capture ◽  
Inverse Dynamics ◽  
Statistical Significance ◽  
Knee Kinematics ◽  
Contact Forces ◽  
Patient Specific ◽  
Functional Evaluation ◽  
Shock Absorption

Abstract Knee osteoarthritis (OA) is a disease that compromises the cartilage inside the knee joint, resulting in pain and impaired mobility. Bracing is a common treatment, however currently prescribed braces cannot treat bicompartmental knee OA, fail to consider the muscle weakness that typically accompanies the disease, and utilize hinges that restrict the knee's natural biomechanics. We have developed and evaluated a brace which addresses these shortcomings. This process has respected three principal design goals: reducing the load experienced across the entire knee joint, generating a supportive moment to aid the muscles in shock absorption, and interfering minimally with gait kinematics. Load reduction is achieved via the compression of medial and lateral leaf springs, and magnetorheological dampers provide the supportive moment during knee loading. A novel, personalized joint mechanism replaces a traditional hinge to reduce interference with knee kinematics. Using motion capture gait analysis, we evaluated the basic functionality of a prototype device. We calculated, via inverse dynamics analysis, the reaction forces at the knee joint and the moments generated by the leg muscles during gait. Comparing these values between braced and unbraced trials allowed us to evaluate the system's effectiveness. Kinematic measurements showed the extent to which the brace interfered with natural gait characteristics. Of the three design goals: a reduction in knee contact forces was demonstrated; increased shock absorption was observed, but not to statistical significance; and natural gait was largely preserved. The techniques presented in this paper could lead to improved OA treatment through patient-specific braces.

Effects of Body Weight Modification on Internal Knee Contact Forces During Gait

2013 ◽  
Author(s):  
Allison L. Kinney ◽  
Heather K. Vincent ◽  
Melinda K. Harman ◽  
James Coburn ◽  
Darryl D. D’Lima ◽  
...  
Keyword(s):  
Body Weight ◽  
Risk Factor ◽  
Knee Joint ◽  
Inverse Dynamics ◽  
Contact Forces ◽  
Weight Changes ◽  
Body Weight Changes ◽  
Total Knee ◽  
Knee Joint Loading ◽  
Knee Load

Obesity is commonly considered a risk factor for the development of knee osteoarthritis [1]. Previous studies have shown that reductions in body weight correspond to reductions in total knee joint compressive forces (as calculated by inverse dynamics) [2–4]. A recent study showed that external knee load measurements are not strong predictors of internal knee contact forces [5]. Therefore, direct measurement of knee contact force is important for understanding how body weight changes impact knee joint loading. Force-measuring knee implants can directly measure internal knee contact forces [6].

Prediction of Knee Joint Contact Forces From External Measures Using Principal Component Prediction and Reconstruction

2018 ◽  
Vol 34 (5) ◽  
pp. 419-423 ◽  
Author(s):  
Christopher M. Saliba ◽  
Allison L. Clouthier ◽  
Scott C.E. Brandon ◽  
Michael J. Rainbow ◽  
Kevin J. Deluzio
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Real Time ◽  
Contact Force ◽  
Haptic Feedback ◽  
Principal Component ◽  
Contact Forces ◽  
Statistical Regression ◽  
Joint Contact Force ◽  
Joint Contact

Abnormal loading of the knee joint contributes to the pathogenesis of knee osteoarthritis. Gait retraining is a noninvasive intervention that aims to reduce knee loads by providing audible, visual, or haptic feedback of gait parameters. The computational expense of joint contact force prediction has limited real-time feedback to surrogate measures of the contact force, such as the knee adduction moment. We developed a method to predict knee joint contact forces using motion analysis and a statistical regression model that can be implemented in near real-time. Gait waveform variables were deconstructed using principal component analysis, and a linear regression was used to predict the principal component scores of the contact force waveforms. Knee joint contact force waveforms were reconstructed using the predicted scores. We tested our method using a heterogenous population of asymptomatic controls and subjects with knee osteoarthritis. The reconstructed contact force waveforms had mean (SD) root mean square differences of 0.17 (0.05) bodyweight compared with the contact forces predicted by a musculoskeletal model. Our method successfully predicted subject-specific shape features of contact force waveforms and is a potentially powerful tool in biofeedback and clinical gait analysis.

Predicting ground reaction and tibiotalar contact forces after total ankle arthroplasty during walking

2020 ◽  
Vol 234 (12) ◽  
pp. 1432-1444
Author(s):  
Yanwei Zhang ◽  
Zhenxian Chen ◽  
Yinghu Peng ◽  
Hongmou Zhao ◽  
Xiaojun Liang ◽  
...  
Keyword(s):  
Motion Capture ◽  
Multibody Dynamics ◽  
Contact Forces ◽  
Total Ankle Arthroplasty ◽  
Contact Model ◽  
Patient Specific ◽  
Ground Reaction Forces ◽  
Ground Contact ◽  
Ankle Arthroplasty ◽  
Reaction Forces

The motion capture and force plates data are essential inputs for musculoskeletal multibody dynamics models to predict in vivo tibiotalar contact forces. However, it could be almost impossible to obtain valid force plates data in old patients undergoing total ankle arthroplasty under some circumstances, such as smaller gait strides and inconsistent walking speeds during gait analysis. To remove the dependence of force plates, this study has established a patient-specific musculoskeletal multibody dynamics model with total ankle arthroplasty by combining a foot-ground contact model based on elastic contact elements. And the established model could predict ground reaction forces, ground reaction moments and tibiotalar contact forces simultaneously. Three patients’ motion capture and force plates data during their normal walking were used to establish the patient-specific musculoskeletal models and evaluate the predicted ground reaction forces and ground reaction moments. Reasonable accuracies were achieved for the predicted and measured ground reaction forces and ground reaction moments. The predicted tibiotalar contact forces for all patients using the foot-ground contact model had good consistency with those using force plates data. These findings suggested that the foot-ground contact model could take the place of the force plates data for predicting the tibiotalar contact forces in other total ankle arthroplasty patients, thus providing a simplified and valid platform for further study of the patient-specific prosthetic designs and clinical problems of total ankle arthroplasty in the absence of force plates data.

scholarly journals A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment

2020 ◽  
Vol 8 ◽  
Author(s):  
Jana Holder ◽  
Ursula Trinler ◽  
Andrea Meurer ◽  
Felix Stief
Keyword(s):  
Knee Joint ◽  
Clinical Decision Making ◽  
Inverse Dynamics ◽  
Clinical Decision ◽  
Contact Forces ◽  
Musculoskeletal Modeling ◽  
Joint Loading ◽  
Joint Moments ◽  
Internal Joint ◽  
Joint Contact

The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.

scholarly journals Validation of a Device to Measure Knee Joint Angles for a Dynamic Movement

Sensors ◽  
2020 ◽  
Vol 20 (6) ◽  
pp. 1747 ◽  
Author(s):  
Mirel Ajdaroski ◽  
Ruchika Tadakala ◽  
Lorraine Nichols ◽  
Amanda Esquivel
Keyword(s):  
Knee Joint ◽  
Motion Capture ◽  
Cruciate Ligament ◽  
Linear Regression Analysis ◽  
Knee Kinematics ◽  
The United States ◽  
Wearable Device ◽  
Joint Angles ◽  
Dynamic Movement ◽  
Flexion Extension

Participation in sports has risen in the United States over the last few years, increasing the risk of injuries such as tears to the anterior cruciate ligament (ACL) in the knee. Previous studies have shown a correlation between knee kinematics when landing from a jump and this injury. The purpose of this study was to validate the ability of a commercially available inertial measurement units (IMUs) to accurately measure knee joint angles during a dynamic movement. Eight healthy subjects participated in the study. Validation was performed by comparing the angles measured by the wearable device to those obtained through the gold standard motion capture system when landing from a jump. Root mean square, linear regression analysis, and Bland–Altman plots were performed/constructed. The mean difference between the wearable device and the motion capture data was 8.4° (flexion/extension), 4.9° (ab/adduction), and 3.9° (rotation). In addition, the device was more accurate at smaller knee angles. In our study, a commercially available wearable IMU was able to perform fairly well under certain conditions and was less accurate in other conditions.

scholarly journals Computational Framework for Determining Patient-Specific Total Knee Arthroplasty Loading

2013 ◽  
Vol 7 (4) ◽  
Author(s):  
Hannah J. Lundberg ◽  
Markus A. Wimmer
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Kinematics ◽  
Contact Forces ◽  
Patient Specific ◽  
Force Model ◽  
Computational Framework ◽  
Knee Joint Kinematics ◽  
Total Knee

The purpose of this work is to describe a computational framework for predicting total knee arthroplasty loads which are necessary for accurate preclinical testing of implant designs. Inputs required include patient knee joint kinematics, and implant type, size, and physiological alignment. Computational models used in the framework include the calculation of knee joint kinematics and kinetics, prediction of the contact path, a model to determine muscle forces, and a force model to obtain parametric solutions for implant forces. The resulting knee implant forces have been validated in two studies, and in both the model accurately predicted differences in knee joint loading. To date, implant contact forces have been predicted for 35 patients with four different implant types. Forces have been calculated for walking, chair, and stair activities.

scholarly journals Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Kyung Wook Nha ◽  
Ariunzaya Dorj ◽  
Jun Feng ◽  
Jun Ho Shin ◽  
Jong In Kim ◽  
...  
Keyword(s):  
Knee Joint ◽  
Lower Extremity ◽  
Knee Osteoarthritis ◽  
Normal Subjects ◽  
Contact Forces ◽  
Flexor Muscle ◽  
Inverse Dynamic ◽  
Joint Force ◽  
Joint Contact ◽  
Muscle Activations

Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments.

scholarly journals The Effect of Correction Algorithms on Knee Kinematics and Kinetics during Gait of Patients with Knee Osteoarthritis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hanna Ulbricht ◽  
Meijin Hou ◽  
Xiangbin Wang ◽  
Jian He ◽  
Yanxin Zhang
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Gait Analysis ◽  
Clinical Decision Making ◽  
Knee Kinematics ◽  
Principal Component ◽  
Clinical Decision ◽  
Joint Angles ◽  
Knee Oa ◽  
Flexion Moment

In gait analysis, the accuracy of knee joint angles and moments is critical for clinical decision-making. The purpose of this study was to determine the efficacy of two existing algorithms for knee joint axis correction under pathological conditions. Gait data from 20 healthy participants and 20 patients with knee osteoarthritis (OA) were collected using a motion capture system. An algorithm based on Principal Component Analysis (PCA) and a functional joint-based algorithm (FJA) were used to define the knee joint flexion axis. The results show that PCA decreased crosstalk for both groups, and FJA reduced crosstalk in patients with knee OA only. PCA decreased the range of motions of patients with knee OA in the direction of abduction/adduction significantly. There was a significant increase in the maximum knee flexion moment of patients with knee OA by FJA. The results indicate that both algorithms can efficiently reduce crosstalk for gait from patients with knee OA, which can further influence the results of knee joint angles and moments. We recommend that the correction algorithms be applied in clinical gait analysis with patients with knee OA.

Correlation Between In Vivo Knee Contact Forces and External Measures During Gait

2012 ◽  
Author(s):  
Andrew J. Meyer ◽  
Darryl D. D’Lima ◽  
Scott A. Banks ◽  
David G. Lloyd ◽  
Thor F. Besier ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Contact Force ◽  
Inverse Dynamics ◽  
Contact Forces ◽  
Clinical Environment ◽  
Total Knee ◽  
Surrogate Measures ◽  
Force Data ◽  
External Measure

Researchers have sought to explain the development and progression of knee osteoarthritis using in vivo estimates of knee contact forces. Unfortunately, it is not possible to measure knee contact forces in a clinical environment. Thus, studies often estimate knee contact forces using a variety of external measures. For example, inverse dynamics knee loads such as the adduction moment and superior force are frequently used as surrogate measures of medial and total knee contact force, respectively. Contraction of muscles spanning the knee is believed to increase knee contact force, and hence muscle electromyographic (EMG) signals are another external measure that may be indicative of internal contact force. The recent development of instrumented knee implants, such as the eTibia design [1], has provided access to in vivo knee contact force data during gait and other activities. However, few studies have correlated inverse dynamics loads, and none have correlated EMG signals, with total, medial, and lateral in vivo knee contact forces.

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