Altering the strength of the muscles crossing the lower limb joints only affects knee joint reaction forces.
Altering the strength of the muscles crossing the lower limb joints only affects knee joint reaction forces.
复制标题
改变穿过下肢关节的肌肉的力量只会影响膝关节的反作用力。
DOI：
10.1016/j.gaitpost.2022.03.020
复制
发表时间：
2022
期刊：
影响因子：
2.4
通讯作者：
L. Modenese
中科院分区：
文献类型：
--
作者：
Metin Bicer;A. Phillips;L. Modenese
背景基于文献数据的通用肌肉骨骼模型通常用于估计关节反作用力（JRF），否则只能进行侵入性测量。估计的JRF对肌肉的最大等长力（F iso）的变化敏感，但这些通常使用乘法系数简单地缩放。在下肢肌肉骨骼模型中，还没有系统地研究过穿过每个下肢关节的肌肉的不同F iso或强度对JRF估计值的影响。研究问题交叉关节肌肉力量的改变如何影响通过通用肌肉骨骼模型计算的下肢JRF幅度？方法通过一次性修改髋、膝、踝或所有关节肌肉的Fiso至±40%，以10%的增量，建立32个模型，以模拟带内固定胫骨假体患者的步态（第5次Grand Challenge数据集）。利用标准工作流程（逆运动学、静态优化、关节反作用分析）计算JRF。由于关节交叉肌肉的强度修改及其对体内膝关节负荷测量的准确性，JRF幅度的变化都进行了量化。结果膝关节JRF是对交叉关节肌肉力量变化最敏感的力（变化范围为− 37.9±0.5%至+ 37.9±3.2%），而髋关节和踝关节JRF几乎不受影响（最大变化：+ 6.1%）。降低膝关节和踝关节交叉肌肉的力量，增强髋关节交叉肌肉的力量降低了膝关节JRF。膝关节JRF的最佳估计值（峰值误差：0.42±0.15体重，均方根误差：0.37±0.06体重，决定系数：0.76±0.10）的模型与-40%削弱交叉膝关节肌肉。显著性改变强度主要影响用通用肌肉骨骼模型估计的膝关节JRF，这表明精确的膝关节JRF估计需要关节交叉肌肉强度的个性化。旨在加强穿过关节的肌肉的康复方案应仔细设计，以避免对其他关节产生不良影响。
Background Generic musculoskeletal models based on literature data are often used to estimate joint reaction forces (JRFs) that otherwise could only be measured invasively. Estimated JRFs are sensitive to changes in maximum isometric force (F iso) of the muscles, but these are normally simply scaled using a multiplicative coefficient. The impact of varying F iso, or strength, of muscles crossing each lower limb joint on estimated JRFs has not been systematically explored in musculoskeletal models of the lower limb. Research Question How do alterations in the strength of joint-crossing muscles influence the lower limb JRF magnitudes computed through a generic musculoskeletal model? Methods By modifying F iso of muscles crossing hip, knee, ankle, or all joints at once up to±40% in 10% increments, thirty-two models were created to simulate the gait of a patient with an instrumented tibial prosthesis (5 th Grand Challenge dataset). A standard workflow (inverse kinematics, static optimization, joint reaction analysis) was utilized to calculate JRFs. Both alterations in JRF magnitudes due to joint crossing muscles’ strength modifications and their accuracy against in vivo knee loading measurements were quantified. Results The knee JRF was the most sensitive force to changes in the joint-crossing muscles’ strength (variations ranging from− 37.9±0.5% to+ 37.9±3.2%), while the hip and ankle JRFs were almost unaffected (maximum variation:+ 6.1%). Reducing the strength of knee and ankle-crossing muscles and intensifying the strength of hip-crossing muscles lowered the knee JRF. The knee JRF was best estimated (peak error: 0.42±0.15 body weight, root mean squared error: 0.37±0.06 body weight, coefficient of determination: 0.76±0.10) by the model with-40% weakened knee-crossing muscles. Significance Altering strengths mainly affects knee JRF estimated with generic musculoskeletal models, suggesting that personalization of strength of joint-crossing muscles is required for accurate knee JRF estimations. Rehabilitation regimes meant to strengthen muscles crossing a joint should be carefully designed to avoid undesired effects on the other joints.
影响因子：
2.4
作者：
Modenese, L.;Phillips, A. T. M.;Bull, A. M. J.
通讯作者：
Bull, A. M. J.
影响因子：
7
作者：
Felson, D. T.
通讯作者：
Felson, D. T.
影响因子：
2.4
作者：
van der Krogt MM;Delp SL;Schwartz MH
通讯作者：
Schwartz MH