Psoas force recruitment in full-body musculoskeletal movement simulations is restored with a geometrically informed cost function weighting.

Simulations of musculoskeletal models are useful for estimating internal muscle and joint forces. However, predicted forces rely on optimization and modeling formulations. Geometric detail is important to predict muscle forces, and greater geometric complexity is required for muscles that have broad attachments or span many joints, as in the torso. However, the extent to which optimized muscle force recruitment is sensitive to these geometry choices is unclear. We developed level, uphill and downhill sloped walking simulations using a standard (uniformly weighted, "fatigue-like") cost function with lower limb and full-body musculoskeletal models to evaluate hip muscle recruitment with different geometric representations of the psoas muscle under walking conditions with varying hip moment demands. We also tested a novel cost function formulation where muscle activations were weighted according to the modeled geometric detail in the full-body model. Total psoas force was less and iliacus, rectus femoris, and other hip flexors' force was greater when psoas was modeled with greater geometric detail compared to other hip muscles for all slopes. The proposed weighting scheme restored hip muscle force recruitment without sacrificing detailed psoas geometry. In addition, we found that lumbar, but not hip, joint contact forces were influenced by psoas force recruitment. Our results demonstrate that static optimization dependent simulations using models comprised of muscles with different amounts of geometric detail bias force recruitment toward muscles with less geometric detail. Muscle activation weighting that accounts for differences in geometric complexity across muscles corrects for this recruitment bias.

Concentric and eccentric hip musculotendon work depends on backpack loads and walking slopes.

Hip muscle weakness is associated with low back and leg injuries. In addition, hiking with heavy loads is linked to high incidence of overuse injuries. Walking with heavy loads on slopes alters hip biomechanics compared to unloaded walking, but individual muscle mechanical work in these challenging conditions is unknown. Using movement simulations, we quantified hip muscle concentric and eccentric work during walking on 0° and ±10° slopes with, and without 40% bodyweight added loads, and with and without a hip belt. For gluteus maximus, psoas, iliacus, gluteus medius, and biceps femoris long head, both concentric and eccentric work were greatest during uphill walking. For rectus femoris and semimembranosus, concentric work was greatest during uphill and eccentric work was greatest during downhill walking. Loaded walking had greater concentric and eccentric work from rectus femoris, biceps femoris long head, and gluteus maximus. Psoas concentric work was greatest while carrying loads regardless of hip belt usage, but eccentric work was only greater than unloaded walking when using a hip belt. Loaded and uphill walking had high concentric work from gluteus maximus, and high eccentric work from gluteus medius and biceps femoris long head. Carrying heavy loads uphill may lead to excessive hip muscle fatigue and heightened injury risk. Effects of the greater eccentric work from hip flexors when wearing a hip belt on lumbar spine forces and pelvic stability should be investigated. Military and other occupational groups who carry heavy backpacks with hip belts should maintain eccentric strength of hip flexors and hamstrings.

Walking slope and heavy backpack loads affect torso muscle activity and kinematics.

The independent effects of sloped walking or carrying a heavy backpack on posture and torso muscle activations have been reported. While the combined effects of sloped walking and backpack loads are known to be physically demanding, how back and abdominal muscles adapt to walking on slopes with heavy load is unclear. This study quantified three-dimensional pelvis and torso kinematics and muscle activity from longissimus, iliocostalis, rectus abdominis, and external oblique during walking on 0° and ± 10° degree slopes with and without backpack loads using two different backpack configurations (hip-belt assisted and shoulder-borne). Iliocostalis activity was greater during downhill and uphill compared to level walking, but longissimus was only greater during uphill. Rectus abdominis activity was greater during downhill and uphill compared to level, while external oblique activity decreased as slopes progressed from down to up. Longissimus, but not iliocostalis, activity was reduced during both backpack configurations compared to walking with no pack. Hip-belt assisted load carriage required less rectus abdominis activity compared to using shoulder-borne only backpacks; however, external oblique was not influenced by backpack condition. Our results revealed different responses between iliocostalis and longissimus, and between rectus abdominis and external obliques, suggesting different motor control strategies between anatomical planes.

Automated optimization of residual reduction algorithm parameters in OpenSim.

The residual reduction algorithm (RRA) in OpenSim is designed to improve dynamic consistency of kinematics and ground reaction forces in movement simulations of musculoskeletal models. RRA requires the user to select numerous tracking weights for the joint kinematics to reduce residual errors. Selection is often performed manually, which can be time-consuming and is unlikely to yield optimal tracking weights. A multi-heuristic optimization algorithm was used to expedite tracking weight decision making to reduce residual errors. This method produced more rigorous results than manual iterations and although the total computation time was not significantly reduced, this method does not require the user to monitor the algorithm's progress to find a solution, thereby reducing manual tuning. Supporting documentation and code to implement this optimization is freely provided to assist the community with developing movement simulations.

A backpack load sharing model to evaluate lumbar and hip joint contact forces during shoulder borne and hip belt assisted load carriage.

Musculoskeletal injuries of the lumbar spine occur frequently among military service members and are associated with heavy backpack loads. Musculoskeletal modeling and simulation facilitate biomechanical evaluation to compare different backpack designs. We developed a backpack attachment model that can be tuned to represent various load distributions between the torso and pelvis. We generated walking simulations to estimate muscle and joint contact forces of unloaded walking and while carrying 38 kg using shoulder-borne backpacks and hip belt-assisted backpacks for six U.S. Marines. Three-dimensional peak and average lumbar (L4-L5) and hip joint contact forces over the stance phase were compared between each load condition. Axial L4-L5 and axial and anterior hip joint contact forces were greater during both backpack conditions compared to the unloaded condition. Joint contact forces were similar between backpack conditions. Future studies incorporating additional participants, walking conditions, and backpack load distributions are suggested for further model development and backpack design evaluation.

Effect of a load distribution system on mobility and performance during simulated and field hiking while under load.

This study was conducted to test a modular scalable vest-load distribution system (MSV-LDS) against the plate carrier system (PC) currently used by the United States Marine Corps. Ten Marines engaged in 1.6 km load carriage trials in seven experimental conditions in a laboratory study. Kinematic, kinetic, and spatiotemporal gait parameters, muscle activity (electromyography), heart rate, caloric expenditure, shooting reaction times, and subjective responses were recorded. There was lower mean trapezius recruitment for the PC compared with the MSV-LDS for all conditions, and muscle activity was similar to baseline for the MSV-LDS. Twenty-seven Marines carrying the highest load were evaluated in the field, which measured an increase in energy expenditure with MSV-LDS; however, back discomfort was reduced. The field evaluation showed significantly reduced estimated ground reaction force on flat-ground segments with the MSV-LDS, and the data suggest both systems were comparable with respect to mobility and energy cost. Practitioner summary: This study found that a novel load distribution system appears to redistribute load for improved comfort as well as reduce estimated ground reaction force when engaged in hiking activities. Further, hiking with a load distribution system enables more neutral walking posture. Implications of load differences in loads carried are examined. Abbreviations: AGRF: anterior-posterior ground reaction forces; CAREN: Computer Assisted Rehabilitation Environment; GRF: ground reaction forces; HR: heart rate; ML-GRF: mediolateral ground reaction forces; MOLLE: Modular Lightweight Load-carrying Equipment; MSV-LDS: modular scalable vest-load distribution system; NHRC: Naval Health Research Center; PC: plate carrier; PPE: personal protective equipment; RPE: rating of perceived exertion; SAPI: small arms protective insert; sEMG: surface electromyography; USMC: United States Marine Corps; VGRF: Ground reaction forces in the vertical.

Head stabilization measurements as a potential evaluation tool for comparison of persons with TBI and vestibular dysfunction with healthy controls.

A large percentage of persons with traumatic brain injury incur some type of vestibular dysfunction requiring vestibular physical therapy. These injuries may affect the natural ability to stabilize the head while walking. A simple method of utilizing motion capture equipment to measure head movement while walking was used to assess improvements in head stabilization of persons undergoing computerized vestibular physical therapy and virtual reality training for treatment of their vestibular problems. Movement data from the head and sacrum during gait were obtained over several visits and then analyzed to determine improved oscillatory head movement relative to the sacrum. The data suggest that, over time with treatment, head stabilization improves and moves toward a pattern similar to that of a healthy control population. This simple analysis of measuring head stability could be transferred to smaller, portable systems that are easily utilized to measure head stability during gait for use in gait assessment and physical therapy training.

Assessing preparative gait adaptations in persons with transtibial amputation in response to repeated medial-lateral perturbations.

Preventing loss of balance in individuals with transtibial amputation is important, as they are susceptible to a high frequency of fall related injuries. In order to validate fall prevention and balance therapies, methods to assess gait stability must be developed. Kinematic, temporal-spatial, and center of mass data from six healthy young participants with transtibial amputation were collected during treadmill walking during exposure to 10 randomly ordered discrete medial-lateral perturbations. The 20 strides prior to each perturbation were assessed for anticipatory changes. The only consistent postural adjustment made as a result of the perturbations was a significantly lowered center of mass height (p=0.016).

Stair ascent kinematics and kinetics with a powered lower leg system following transtibial amputation.

During stair ascent (STA) persons with transtibial amputation (TTA) typically adopt a hip strategy to compensate for the limited ankle motion and joint power that is characteristic of conventional energy storing and returning (ESR) prosthetic feet. The purpose of this investigation was to determine if providing ankle power via a powered prosthetic device (BiOM) normalized STA kinematics and kinetics. Eleven individuals with TTA participated in two STA gait analysis sessions: (1) using an ESR foot, and (2) using the BiOM. Eleven height and weight matched able-bodied controls (CONT) were also assessed. Lower extremity peak kinematic and kinetic values were calculated at a self-selected and controlled cadence (80 steps/min). Increased prosthetic limb peak ankle plantarflexion and push-up power were observed while using the BiOM as compared to ESR. Peak ankle power was not significantly different between BiOM and CONT indicating normalization of ankle power generation. However, peak ankle plantarflexion was significantly lower than CONT. Limb asymmetries including greater prosthetic limb hip flexion and power during stance, and decreased prosthetic limb knee power during stance were observed in the BiOM and ESR conditions. The results suggest that the BiOM successfully increased ankle motion and restored ankle power during STA. These differences did not, however, reduce the use of a hip strategy while ascending stairs. Additional device specific training may be necessary to utilize the full benefits of the device.