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.

人体及其部位的运动和载荷的知识在人类医学的许多领域中是必不可少的，特别是在整形外科和创伤外科中。现代数值方法已经发展到这样的程度，即它们对于基于先验知识的运动和外部载荷来估计相关结构中的力是有用的。然而，它们的一般用途受到限制，因为它们不能响应于由疾病引起的身体变化或作为应用给定疗法治疗疾病的结果来预测运动和负载。该项目的目的是开发新一代的前向模拟器，基于最佳运动的计算，预测并改善个体患者的治疗策略。这种模拟器将有助于将医学从纯粹的经验方法（依赖于仅基于证据的治疗方法的演变）转移到指导和预测治疗方法成为可能的程度。一个创新的前向肌肉骨骼模拟器（FMS）将开发和实现这一目的。虽然模拟器可以在未来应用于广泛的肌肉骨骼疾病，它将首先进行测试，并在三个特别选择的临床情况下进一步发展：膝关节和踝关节支撑，足下垂病理学，膝关节截肢治疗与微处理器控制的膝关节假体。选择这三种临床情况是因为它们具有良好的特征，可以无创地改变治疗方式，而不会给患者带来不当风险，并且有足够数量的患者可用。虽然相对简单，但每一种病理都严重降低了受影响患者的生活质量，治疗方法的普遍改善，特别是治疗方式的调整，以适应个别患者的需要，将对生活质量产生严重影响。在这三种情况下，将在临床步态分析实验室的背景下开发框架，通过使用直接运动学和动力学测量以及逆动力学模拟的组合作为从相应患者集体获得的地面真实数据来验证和进一步开发。FMS预测能力的未来应用的最明显领域之一是髋关节和膝关节的高级OA的治疗，即全髋关节（THA）和全膝关节置换术（TKA）。这些程序的成本是一个重大的和日益增长的经济挑战。这进一步表明了该项目中进行的基础研究的重要性，并展示了重大的医学和经济影响：改善治疗，并提供强大的新方法来预测与肌肉骨骼疾病相关的许多情况下的治疗结果。