Biofeedback for Gait Retraining Based on Real-Time Estimation of Tibiofemoral Joint Contact Forces.
Biofeedback for Gait Retraining Based on Real-Time Estimation of Tibiofemoral Joint Contact Forces.
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DOI：
10.1109/tnsre.2017.2683488
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Lloyd DG
中科院分区：
文献类型：
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作者：
Pizzolato C;Reggiani M;Saxby DJ;Ceseracciu E;Modenese L;Lloyd DG
生物反馈辅助康复和干预技术有可能改变临床相关的生物力学。步态再训练已被用于减少膝关节内收力矩，内收力矩是膝关节骨性关节炎研究中常用的胫骨股骨内侧关节负荷的代替物。在这项研究中，我们提出了一个肌电图驱动的下肢神经肌肉骨骼模型来实时估计胫股关节负荷。该模型包括34个横跨髋关节、膝关节和踝关节的肌肉肌腱单元。根据运动捕捉和力板数据实时求解全身逆运动学、逆动力学和肌肉肌腱运动学，以估计膝关节内侧胫股接触力（MTFF）。我们分析了5名健康受试者在仪器跑步机上行走时MTFF的视觉生物反馈。每个受试者被要求改变他们的步态，以改变他们的MTFF的大小。所有受试者都能够增加他们的MTFF，而只有3名受试者能够降低MTFF，并且只有在接受有关可能的步态改变策略的口头建议后。结果表明，膝关节肌肉激活模式在调节MTFF中的重要作用。虽然这项研究主要集中在膝盖上，但这项技术可以扩展到检查人体不同部位的肌肉骨骼组织负荷。
Biofeedback assisted rehabilitation and intervention technologies have the potential to modify clinically relevant biomechanics. Gait retraining has been used to reduce the knee adduction moment, a surrogate of medial tibiofemoral joint loading often used in knee osteoarthritis research. In this study we present an electromyogram-driven neuromusculoskeletal model of the lower-limb to estimate, in real-time, the tibiofemoral joint loads. The model included 34 musculotendon units spanning the hip, knee, and ankle joints. Full-body inverse kinematics, inverse dynamics, and musculotendon kinematics were solved in real-time from motion capture and force plate data to estimate the knee medial tibiofemoral contact force (MTFF). We analyzed 5 healthy subjects while they were walking on an instrumented treadmill with visual biofeedback of their MTFF. Each subject was asked to modify their gait in order to vary the magnitude of their MTFF. All subjects were able to increase their MTFF, whereas only 3 subjects could decrease it, and only after receiving verbal suggestions about possible gait modification strategies. Results indicate the important role of knee muscle activation patterns in modulating the MTFF. While this study focused on the knee, the technology can be extended to examine the musculoskeletal tissue loads at different sites of the human body.