Musculoskeletal Model Personalization Affects Metabolic Cost Estimates for Walking

Arones, Marleny M.; Shourijeh, Mohammad S.; Patten, Carolynn; Fregly, Benjamin J.

doi:10.1101/2020.08.05.238857

Cited by 3 publications

(2 citation statements)

References 60 publications

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“…studies have identified sensitivities to muscle parameters in both metabolic cost estimates of poststroke gait [75] and contact forces in the knee of an amputee walking with a prosthesis [76]. An additional source of further work for our framework will be to investigate the potential of musculoskeletal model calibration techniques [77] in combination with alternative objective functions, with the aim to recruit patients with gait pathologies.…”

Section: B Simulated Metabolic Costmentioning

confidence: 99%

Human-in-the-Loop Optimization of Exoskeleton Assistance Via Online Simulation of Metabolic Cost

et al. 2022

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Many assistive robotic devices have been developed to augment or assist human locomotion. Despite advancements in design and control algorithms, this task remains challenging. Human walking strategies are unique and complex, and assistance strategies based on the dynamics of unassisted locomotion typically offer only modest reductions to the metabolic cost of walking. Recently, human-in-the-loop (HIL) methodologies have been used to identify subject-specific assistive strategies, which offer significant improvements to energy savings. However, current implementations suffer from long measurement times, necessitating the use of low-dimensional control parameterizations, and possibly requiring multiday collection protocols to avoid subject fatigue. We present a HIL methodology, which optimizes the assistive torques provided by a powered hip exoskeleton. Using musculoskeletal modeling, we are able to evaluate simulated metabolic rate online. We applied our methodology to identify assistive torque profiles for seven subjects walking on a treadmill, and found greater reductions to metabolic cost when compared to generic or off-the-shelf controllers. In a secondary investigation, we directly compare simulated and measured metabolic rate for three subjects experiencing a range of assistance levels. The time investment required to identify assistance strategies via our protocol is significantly lower when compared to existing protocols relying on calorimetry. In the future, frameworks such as these could be used to enable shorter HIL protocols or exploit more complex control parameterizations for greater energy savings.

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Section: B Simulated Metabolic Costmentioning

confidence: 99%

Human-in-the-Loop Optimization of Exoskeleton Assistance Via Online Simulation of Metabolic Cost

et al. 2022

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“…Metabolic cost is defined as the energy consumed by the body during a given activity, in this case, a single walking cycle. Based on a previous study (Arones et al, 2020), we used Bhargava's model to calculate the metabolic cost (Bhargava et al, 2004). Stride length is defined as the distance between two consecutive heel strikes of the same foot.…”

Section: Gluteus Minimus (Posterior)mentioning

confidence: 99%

Computational evaluation of psoas muscle influence on walking function following internal hemipelvectomy with reconstruction

Vega

Li²,

Shourijeh³

et al. 2022

Front. Bioeng. Biotechnol.

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An emerging option for internal hemipelvectomy surgery is custom prosthesis reconstruction. This option typically recapitulates the resected pelvic bony anatomy with the goal of maximizing post-surgery walking function while minimizing recovery time. However, the current custom prosthesis design process does not account for the patient’s post-surgery prosthesis and bone loading patterns, nor can it predict how different surgical or rehabilitation decisions (e.g., retention or removal of the psoas muscle, strengthening the psoas) will affect prosthesis durability and post-surgery walking function. These factors may contribute to the high observed failure rate for custom pelvic prostheses, discouraging orthopedic oncologists from pursuing this valuable treatment option. One possibility for addressing this problem is to simulate the complex interaction between surgical and rehabilitation decisions, post-surgery walking function, and custom pelvic prosthesis design using patient-specific neuromusculoskeletal models. As a first step toward developing this capability, this study used a personalized neuromusculoskeletal model and direct collocation optimal control to predict the impact of ipsilateral psoas muscle strength on walking function following internal hemipelvectomy with custom prosthesis reconstruction. The influence of the psoas muscle was targeted since retention of this important muscle can be surgically demanding for certain tumors, requiring additional time in the operating room. The post-surgery walking predictions emulated the most common surgical scenario encountered at MD Anderson Cancer Center in Houston. Simulated post-surgery psoas strengths included 0% (removed), 50% (weakened), 100% (maintained), and 150% (strengthened) of the pre-surgery value. However, only the 100% and 150% cases successfully converged to a complete gait cycle. When post-surgery psoas strength was maintained, clinical gait features were predicted, including increased stance width, decreased stride length, and increased lumbar bending towards the operated side. Furthermore, when post-surgery psoas strength was increased, stance width and stride length returned to pre-surgery values. These results suggest that retention and strengthening of the psoas muscle on the operated side may be important for maximizing post-surgery walking function. If future studies can validate this computational approach using post-surgery experimental walking data, the approach may eventually influence surgical, rehabilitation, and custom prosthesis design decisions to meet the unique clinical needs of pelvic sarcoma patients.

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A Conceptual Blueprint for Making Neuromusculoskeletal Models Clinically Useful

Fregly

2021

Applied Sciences

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The ultimate goal of most neuromusculoskeletal modeling research is to improve the treatment of movement impairments. However, even though neuromusculoskeletal models have become more realistic anatomically, physiologically, and neurologically over the past 25 years, they have yet to make a positive impact on the design of clinical treatments for movement impairments. Such impairments are caused by common conditions such as stroke, osteoarthritis, Parkinson’s disease, spinal cord injury, cerebral palsy, limb amputation, and even cancer. The lack of clinical impact is somewhat surprising given that comparable computational technology has transformed the design of airplanes, automobiles, and other commercial products over the same time period. This paper provides the author’s personal perspective for how neuromusculoskeletal models can become clinically useful. First, the paper motivates the potential value of neuromusculoskeletal models for clinical treatment design. Next, it highlights five challenges to achieving clinical utility and provides suggestions for how to overcome them. After that, it describes clinical, technical, collaboration, and practical needs that must be addressed for neuromusculoskeletal models to fulfill their clinical potential, along with recommendations for meeting them. Finally, it discusses how more complex modeling and experimental methods could enhance neuromusculoskeletal model fidelity, personalization, and utilization. The author hopes that these ideas will provide a conceptual blueprint that will help the neuromusculoskeletal modeling research community work toward clinical utility.

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Musculoskeletal Model Personalization Affects Metabolic Cost Estimates for Walking

Cited by 3 publications

References 60 publications

Human-in-the-Loop Optimization of Exoskeleton Assistance Via Online Simulation of Metabolic Cost

Human-in-the-Loop Optimization of Exoskeleton Assistance Via Online Simulation of Metabolic Cost

Computational evaluation of psoas muscle influence on walking function following internal hemipelvectomy with reconstruction

A Conceptual Blueprint for Making Neuromusculoskeletal Models Clinically Useful

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