OMEGA - Optimization-based forward musculoskeletal simulation of pathological gait

OMEGA - 基于优化的病理步态前向肌肉骨骼模拟

• 批准号: 316739714
• 负责人: Professor Dr. Christof Hurschler
• 金额: --
• 依托单位: Labor für Biomechanik und Biomaterialien
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/316739714?language=en
• 关键词: OMEGA; Optimization; based; forward; musculoskeletal

Knowledge of the motion and loading of the human body and its parts is essential in many fields of human medicine and in particular in orthopedic and trauma surgery. Modern numerical methods have advanced to the point that they are useful for estimating forces in the relevant structures based on a priori knowledge motion and external loading. However, their general usefulness is limited by their inability to predict motion and loading in response to changes in the body caused by disease or as a result of applying a given therapy to treat a disease. The aim of this project is to develop a new generation of forward simulator, based on the computation of most optimal motions, with the promise of predicting and thus improving therapeutic strategies for individual patients. Such simulator will help moving medicine away from a purely empirical approach which relies on the evolution of therapies based on evidence alone, to a point where guiding and predicting therapies is possible. An innovative forward musculoskeletal simulator (FMS) will be developed and implemented for this purpose. Although the simulator could in the future be applied to a wide range of musculoskeletal disorders it will first be tested and further evolved in three specially selected clinical situations: Knee and Ankle Bracing, Drop Foot Pathology, and Above Knee Amputation treated with a microprocessor-controlled knee-prosthesis. These three clinical situations were chosen because they are well characterized, treatments modalities can be altered non-invasively without undue risk to the patients, and sufficient numbers of patients are available. Although relatively simple, each of these pathologies represents a serious reduction in quality of life for the affected patients and general improvements in treatment approaches and in particular the adaptation of treatment modalities to the needs of individual patients will have a serious impact on quality of life. In all three cases a framework will be developed in the context of a clinical gait analysis laboratory, validated and further developed by using a combination of direct kinematic and kinetic measurements and inverse dynamic simulations as ground-truth data obtained from respective patient collectives.One of the most obvious areas of future application of the predictive capabilities of FMS is the treatment of advanced OA of the hip and knee, i.e. total hip (THA) and total knee arthroplasty (TKA). The cost of these procedures represents a significant and increasing economic challenge. This is a further indication of the significance of the basic-research to be performed in this project and demonstrates a major medical and economic impact: improving the treatment of, and providing powerful new methods for predicting the outcome of treatments in many contexts related to musculoskeletal diseases.

在许多人类医学领域，尤其是在骨科和创伤手术中，了解人体及其部分的运动和负载是必不可少的。现代的数值方法已经发展到它们对基于先验知识运动和外部负载中相关结构中估算力的力很有用。但是，它们的总体用途受到其无法预测运动和负载的限制，以响应疾病引起的身体变化或应用给定疗法治疗疾病而导致的身体变化。该项目的目的是根据最佳动作的计算开发新一代的前向模拟器，并有望预测并改善各个患者的治疗策略。这种模拟器将有助于医学从仅基于证据的疗法的演变而来，从而将医学从纯粹的经验方法中移开，从而可以指导和预测疗法。为此，将开发和实施创新的前向肌肉骨骼模拟器（FMS）。尽管将来可以将模拟器应用于多种肌肉骨骼疾病中，它将首先测试并在三种特殊选择的临床情况下进一步进化：膝盖和脚踝支撑，掉落的脚部病理学，脚下脚部病理，并在膝盖截肢上用微医师控制的膝盖膝关节截肢治疗。之所以选择这三种临床情况，是因为它们具有很好的特征，治疗方式可以非侵入性地改变，而不会对患者进行过多风险，并且有足够的患者可用。尽管相对简单，但这些病理中的每一个都代表着受影响的患者的生活质量的严重降低，并且对治疗方法的一般改善，尤其是将治疗方式适应了个别患者的需求，将对生活质量产生严重影响。在所有三种情况下，在临床步态分析实验室的背景下，通过使用直接的运动和动力学测量和动态模拟的结合来制定框架，并进一步开发框架，作为从各自的患者集体中获得的地面数据，FMS的未来最明显的领域之一是FMS的未来最明显的领域之一。关节置换术（TKA）。这些程序的成本代表了一个重大且日益严重的经济挑战。这进一步迹象表明，基础研究在该项目中要进行的重要性，并证明了重大的医学和经济影响：改善对治疗方法，并提供有力的新方法来预测与肌肉骨骼疾病有关的许多情况下治疗的结果。