OMEGA - Optimization-based forward musculoskeletal simulation of pathological gait

点击翻译按钮获取中文摘要

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.