Searching for strategies to reduce the mechanical demands of the sit-to-stand task with a muscle-actuated optimal control model
Searching for strategies to reduce the mechanical demands of the sit-to-stand task with a muscle-actuated optimal control model
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DOI：
10.1016/j.clinbiomech.2016.06.008
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发表时间：
2016-08-01
影响因子：
1.8
通讯作者：
Ackermann, Marko
中科院分区：
文献类型：
--
作者：
Bobbert, Maarten F.;Kistemaker, Dinant A.;Ackermann, Marko
背景：从坐到站的任务，包括从坐在椅子上独立地站起来，在日常生活中很重要。许多患有肌肉无力、运动范围减少或特定关节负荷相关疼痛的人难以执行任务。患有这种损伤的人应该如何最好地执行坐立任务，并且在特定关节疼痛的情况下，减少该关节的负荷？方法：我们开发了一个肌肉骨骼模型与参考参数值的基础上健康强壮的主体的属性。该模型的肌肉刺激时间的输入进行了优化，使用直接搭配，以找到策略，产生成功的坐站任务性能与最小的“控制努力”的参考集和修改后的参数值集，并与胫股压缩力的约束。参考模型可以成功地和真实地执行坐到站任务，通过将等长膝伸肌力减少到参考值的40%的模型，通过将所有肌肉的等长力减少到参考值的45%的模型，以及参考模型，优化期间胫股压缩力限制为参考条件下峰值的65%。解释：该模型在非参考条件下发现的策略可以很好地解释成本函数和任务生物力学的基础上。问题仍然是它是否是可行的，教患者与肌肉骨骼损伤或关节疼痛，以执行坐立任务的策略，根据模拟模型是最佳的。(C)2016爱思唯尔有限公司版权所有
Background: The sit-to-stand task, which involves rising unassisted from sitting on a chair to standing, is important in daily life. Many people with muscle weakness, reduced range of motion or loading-related pain in a particular joint have difficulty performing the task. How should a person suffering from such impairment best perform the sit-to-stand task and, in the case of pain in a particular joint, with reduced loading of that joint?Methods: We developed a musculoskeletal model with reference parameter values based on properties of healthy strong subjects. The model's muscle stimulation-time input was optimized using direct collocation to find strategies that yielded successful sit-to-stand task performance with minimum 'control effort' for the reference set and modified sets of parameter values, and with constraints on tibiofemoral compression force.Findings: The sit-to-stand task could be performed successfully and realistically by the reference model, by a model with isometric knee extensor forces reduced to 40% of reference, by a model with isometric forces of all muscles reduced to 45% of reference, and by the reference model with the tibiofemoral compression force constrained during optimization to 65% of the peak value in the reference condition.Interpretation: The strategies found by the model in conditions other than reference could be interpreted well on the basis of cost function and task biomechanics. The question remains whether it is feasible to teach patients with musculoskeletal impairments or joint pain to perform the sit-to-stand task according to strategies that are optimal according to the simulation model. (C) 2016 Elsevier Ltd. All rights reserved.