Ground reaction forces and moments (GRF&M) are important measures used as input in biomechanical analysis to estimate joint kinetics, which often are used to infer information for many musculoskeletal diseases. Their assessment is conventionally achieved using laboratory-based equipment that cannot be applied in daily life monitoring. In this study, we propose a method to predict GRF&M during walking, using exclusively kinematic information from fully-ambulatory inertial motion capture (IMC). From the equations of motion, we derive the total external forces and moments. Then, we solve the indeterminacy problem during double stance using a distribution algorithm based on a smooth transition assumption. The agreement between the IMC-predicted and reference GRF&M was categorized over normal walking speed as excellent for the vertical (ρ = 0.992, rRMSE = 5.3%), anterior (ρ = 0.965, rRMSE = 9.4%) and sagittal (ρ = 0.933, rRMSE = 12.4%) GRF&M components and as strong for the lateral (ρ = 0.862, rRMSE = 13.1%), frontal (ρ = 0.710, rRMSE = 29.6%), and transverse GRF&M (ρ = 0.826, rRMSE = 18.2%). Sensitivity analysis was performed on the effect of the cut-off frequency used in the filtering of the input kinematics, as well as the threshold velocities for the gait event detection algorithm. This study was the first to use only inertial motion capture to estimate 3D GRF&M during gait, providing comparable accuracy with optical motion capture prediction. This approach enables applications that require estimation of the kinetics during walking outside the gait laboratory.

This article describes the development of a musculoskeletal model of the human lumbar spine with focus on back muscles. It includes data from literature in a structured form. To review the anatomy and biomechanics of the back muscles related to the lumbar spine with relevance for biomechanical modeling. To reduce complexity, muscle units have been incorporated in an abridged manner, reducing their actions more or less to a single force equivalent. In early models of the lumbar spine, this may have been a necessary step to reduce complexity and, thereby, calculation time. The muscles of the spine are well described in the literature, but mainly qualitatively. Most of the literature provides a description of the structures without precise data of fiber length, muscle length, cross-sectional areas, moment arms, forces, etc. The predicted output of musculoskeletal models is very much dependent on the input parameters. The information needed to improve models consists of better approximations of the attachments to the vertebrae, and more precise data. Review of literature. The predicted output of musculoskeletal models is very much dependent on the input parameters. Moderate changes in the assumed muscle line-of-action (i.e., moment arm) could substantially alter the magnitudes of predicted muscle and spinal forces, while the choice of optimization formulation is less sensitive. Input parameters, moment arms, as well as physiologic cross-sectional areas have a profound effect on the predicted muscle forces. Therefore, it is important to choose the values for moment arm and physiologic cross-sectional area carefully because they are essential input parameters to biomechanical models.

Subject-specific scaling of cadaver-based musculoskeletal models is important for accurate musculoskeletal analysis within multiple areas such as ergonomics, orthopaedics and occupational health. We present two procedures to scale ‘generic’ musculoskeletal models to match segment lengths and joint parameters to a specific subject and compare the results to a simpler approach based on linear, segment-wise scaling. By incorporating data from functional and standing reference trials, the new scaling approaches reduce the model sensitivity to assumed model marker positions. For validation, we applied all three scaling methods to an inverse dynamics-based musculoskeletal model and compared predicted knee joint contact forces to those measured with an instrumented prosthesis during gait. Additionally, a Monte Carlo study was used to investigate the sensitivity of the knee joint contact force to random adjustments of the assumed model marker positions (+/− one marker diameter). The model based on linear scaling showed the highest variation in the knee joint contact force of 1.44 body weight (BW) around contra-lateral heel strike, and a variation in root mean square deviation (RMSD) of 0.36 BW. The proposed methods reduced the variation to 1.0 BW (RMSD 0.26 BW) for the anatomical landmark based method and 0.47 BW (RMSD 0.06 BW) for the functional based method. Variation in model predictions due to uncertainty in marker positions is a trait of all marker-based musculoskeletal modelling approaches. The presented methods solve part of this problem and rely less on manual identification of anatomical landmarks in the model. The work represents a step towards a more consistent methodology in musculoskeletal modelling.

Inverse dynamic analysis using musculoskeletal modeling is a powerful tool, which is utilized in a range of applications to estimate forces in ligaments, muscles, and joints, non-invasively. To date, the conventional input used in this analysis is derived from optical motion capture (OMC) and force plate (FP) systems, which restrict the application of musculoskeletal models to gait laboratories. To address this problem, we propose the use of inertial motion capture to perform musculoskeletal model-based inverse dynamics by utilizing a universally applicable ground reaction force and moment (GRF&M) prediction method. Validation against a conventional laboratory-based method showed excellent Pearson correlations for sagittal plane joint angles of ankle, knee, and hip (ρ=0.95, 0.99, and 0.99, respectively) and root-mean-squared-differences (RMSD) of 4.1 ± 1.3°, 4.4 ± 2.0°, and 5.7 ± 2.1°, respectively. The GRF&M predicted using IMC input were found to have excellent correlations for three components (vertical: ρ=0.97, RMSD = 9.3 ± 3.0 %BW, anteroposterior: ρ=0.91, RMSD = 5.5 ± 1.2 %BW, sagittal: ρ=0.91, RMSD = 1.6 ± 0.6 %BW*BH), and strong correlations for mediolateral (ρ=0.80, RMSD = 2.1 ± 0.6 %BW) and transverse (ρ=0.82, RMSD = 0.2 ± 0.1 %BW*BH). The proposed IMC-based method removes the complexity and space restrictions of OMC and FP systems and could enable applications of musculoskeletal models in either monitoring patients during their daily lives or in wider clinical practice.