A Lower Extremity Neuromusculoskeletal Human Simulator: Addressing Multiscale Challenges

项目摘要/摘要 我们的愿景是通过创建数据和模型来表示人类肌肉骨骼系统， 现实主义需要理解病理学并改进治疗。人体天生就是多尺度的。 疾病和损伤往往在微观结构范围内影响组织；小规模的病理影响 更大规模的生物力学，导致全身运动补偿，这通常会促进 进一步伤害或加速退化。最终，一种多尺度的方法，描述了 个体组织和整个身体的生物力学是阐明疾病病因所必需的， 适应机制和最佳治疗。这项提案的总体目标是创建一个全面的 包含无缝连接的人体下肢多尺度神经肌肉骨骼模型 在动态人类活动期间组织和全身功能之间的关系，并使现实的研究成为可能 肌肉骨骼疾病和治疗。虽然我们将创建和共享具有广泛适用性的模型 生物力学，我们的目标是了解膝骨性关节炎(OA)对患者功能和 通过全膝关节置换(TKA)优化治疗。骨性关节炎是一种严重的退行性关节疾病， 老年人残疾的主要原因。此外，骨质疏松症与许多紧迫的健康问题密切相关， 包括肥胖、心血管疾病、阿尔茨海默病、痴呆症和抑郁症。接合 替代疗法仍然是治疗晚期骨性关节炎的唯一有效方法。不幸的是，多达20%-30%的 关节置换患者报告疼痛，需要额外的手术，并忍受与运动相关的不良反应。 生活质量。我们研究的一个宗旨是使用人体建模和模拟来研究多尺度 OA对患者的影响，并改进关节置换手术的设计和实践。

PROJECT SUMMARY / ABSTRACT Our vision is to represent the human musculoskeletal system, through the creation of data and models, with the realism needed to understand pathology and improve treatment. The human body is inherently multiscale. Diseases and injuries often affect tissues at the microstructural scale; small-scale pathology impacts biomechanics at larger scales, leading to whole-body movement compensations that oftentimes promote further injury or accelerate degeneration. Ultimately, a multiscale approach, describing the behavior of individual tissues, and the biomechanics of the whole body, is needed to elucidate the etiology of diseases, mechanisms of adaptation and best treatments. The overall goal of this proposal is to create a comprehensive multiscale neuromusculoskeletal model of the human lower extremity, which includes seamless connection between tissue and whole-body function during dynamic human activities and enables realistic investigations of musculoskeletal disease and treatment. While we will create and share models with broad applicability in biomechanics, our target is understanding the effects of knee osteoarthritis (OA) on patient function and optimizing treatment through total knee arthroplasty (TKA). OA is a serious degenerative joint disease and the leading cause of disability in the elderly. Moreover, OA is interrelated with many pressing health concerns, including obesity, cardiovascular disease (CVD), Alzheimer’s disease, dementia, and depression. Joint replacement remains the only effective treatment for advanced OA. Unfortunately, as many as 20-30% of total joint replacement patients report pain, require additional surgeries, and endure a poor movement-related quality of life. A tenet of our research is the use of human modeling and simulation to investigate the multiscale effects of OA on patients, and to improve the design and practice of joint replacement surgery.