Sensitivity analysis of human lower extremity joint moments due to changes in joint kinematics.

Despite the widespread applications of human gait analysis, causal interactions between joint kinematics and joint moments have not been well documented. Typical gait studies are often limited to pure multi-body dynamics analysis of a few subjects which do not reveal the relative contributions of joint kinematics to joint moments. This study presented a computational approach to evaluate the sensitivity of joint moments due to variations of joint kinematics. A large data set of probabilistic joint kinematics and associated ground reaction forces were generated based on experimental data from literature. Multi-body dynamics analysis was then used to calculate joint moments with respect to the probabilistic gait cycles. Employing the principal component analysis (PCA), the relative contributions of individual joint kinematics to joint moments were computed in terms of sensitivity indices (SI). Results highlighted high sensitivity of (1) hip abduction moment due to changes in pelvis rotation (SI = 0.38) and hip abduction (SI = 0.4), (2) hip flexion moment due to changes in hip flexion (SI = 0.35) and knee flexion (SI = 0.26), (3) hip rotation moment due to changes in pelvis obliquity (SI = 0.28) and hip rotation (SI = 0.4), (4) knee adduction moment due to changes in pelvis rotation (SI = 0.35), hip abduction (SI = 0.32) and knee flexion (SI = 0.34), (5) knee flexion moment due to changes in pelvis rotation (SI = 0.29), hip flexion (SI = 0.28) and knee flexion (SI = 0.31), and (6) knee rotation moment due to changes in hip abduction (SI = 0.32), hip flexion and knee flexion (SI = 0.31). Highlighting the "cause-and-effect" relationships between joint kinematics and the resultant joint moments provides a fundamental understanding of human gait and can lead to design and optimization of current gait rehabilitation treatments.

[1]  P. Requejo,et al.  Joint moment contributions to swing knee extension acceleration during gait in children with spastic hemiplegic cerebral palsy. , 2010, Journal of biomechanics.

[2]  Marlene Fransen.  Rehabilitation after knee replacement surgery for osteoarthritis , 2011 .

[3]  Stiff-knee gait in cerebral palsy: how do patients adapt to uneven ground? , 2014, Gait & posture.

[4]  N. B. Jones,et al.  Modelling of knee joint muscles during the swing phase of gait--a forward dynamics approach using MATLAB/Simulink , 2003, Simul. Model. Pract. Theory.

[5]  D. Howard,et al.  Whole body inverse dynamics over a complete gait cycle based only on measured kinematics. , 2008, Journal of biomechanics.

[6]  A Cappello,et al.  Effects of hip joint centre mislocation on gait analysis results. , 2000, Journal of biomechanics.

[7]  J. Perry,et al.  Gait Analysis , 2024 .

[8]  Simon Haykin,et al.  Neural Networks and Learning Machines , 2010 .

[9]  Hélène Moffet,et al.  Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: A single-blind randomized controlled trial. , 2004, Archives of physical medicine and rehabilitation.

[10]  Clare K Fitzpatrick,et al.  Combined probabilistic and principal component analysis approach for multivariate sensitivity evaluation and application to implanted patellofemoral mechanics. , 2011, Journal of biomechanics.

[11]  Robin M Queen,et al.  Total hip arthroplasty surgical approach does not alter postoperative gait mechanics one year after surgery. , 2014, PM & R : the journal of injury, function, and rehabilitation.

[12]  Kate E Webster,et al.  Quantitative gait analysis in patients with dementia with Lewy bodies and Alzheimer's disease. , 2007, Gait & posture.

[13]  Marcus G Pandy,et al.  Grand challenge competition to predict in vivo knee loads , 2012, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[14]  Ralf Mikut,et al.  Gait analysis may help to distinguish hereditary spastic paraplegia from cerebral palsy. , 2011, Gait & posture.

[15]  Sandra G Brauer,et al.  A specific inpatient aquatic physiotherapy program improves strength after total hip or knee replacement surgery: a randomized controlled trial. , 2009, Archives of physical medicine and rehabilitation.

[16]  J. Barrios,et al.  Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment. , 2010, Journal of biomechanics.

[17]  Ling Wang,et al.  A neural network approach for determining gait modifications to reduce the contact force in knee joint implant. , 2014, Medical engineering & physics.

[18]  Mark Taylor,et al.  Development of a statistical model of knee kinetics for applications in pre-clinical testing. , 2012, Journal of biomechanics.

[19]  A. St. Clair Gibson,et al.  Gait analysis of fixed bearing and mobile bearing total knee prostheses during walking: do mobile bearings offer functional advantages? , 2014, The Knee.

[20]  Yujiang Xiang,et al.  Optimization-based prediction of asymmetric human gait. , 2011, Journal of biomechanics.

[21]  Jonathan P. Walter,et al.  Decreased Knee Adduction Moment Does Not Guarantee Decreased Medial Contact Force During Gait , 2009 .

[22]  I. Jolliffe.  Principal Component Analysis , 2002 .

[23]  Zhongmin Jin,et al.  Gait modification and optimization using neural network-genetic algorithm approach: Application to knee rehabilitation , 2014, Expert Syst. Appl..

[24]  David Isaac,et al.  Accelerated rehabilitation after total knee replacement. , 2005, The Knee.

[25]  Ahnryul Choi,et al.  Prediction of ground reaction forces during gait based on kinematics and a neural network model. , 2013, Journal of biomechanics.

[26]  Thompson Sarkodie-Gyan,et al.  Measurement of functional impairments in human locomotion using pattern analysis , 2011 .

[27]  M. Hunt,et al.  Feasibility of a gait retraining strategy for reducing knee joint loading: increased trunk lean guided by real-time biofeedback. , 2011, Journal of biomechanics.

[28]  Jeffrey A. Reinbolt,et al.  From the Selectedworks of Jeffrey A. Reinbolt Design of Patient-specific Gait Modifications for Knee Osteoarthritis Rehabilitation Design of Patient-specific Gait Modifications for Knee Osteoarthritis Rehabilitation , 2022 .

[29]  S. Kelley,et al.  Does surgical approach during total hip arthroplasty alter gait recovery during the first year following surgery? , 2013, The Journal of arthroplasty.

[30]  M. Hunt,et al.  Lateral trunk lean explains variation in dynamic knee joint load in patients with medial compartment knee osteoarthritis. , 2008, Osteoarthritis and cartilage.

[31]  Javier Cuadrado,et al.  Analysis of different uncertainties in the inverse dynamic analysis of human gait , 2012 .

[32]  Alfred D. Grant.  Gait Analysis: Normal and Pathological Function , 2010 .

[33]  J. Perry,et al.  Comprar Gait analysis. Normal and pathological function | Burnfield, J. | 9781556427664 | Slack Incorporated , 2010 .

[34]  Paul Allard,et al.  Three-Dimensional Analysis of Human Locomotion , 1998 .

[35]  Klein Horsman,et al.  The Twente lower extremity model : consistent dynamic simulation of the human locomotor apparatus , 2007 .

[36]  Y. DeWoody,et al.  A forward dynamic model of gait with application to stress analysis of bone , 2001 .

[37]  S. Stanhope,et al.  Sensitivity of joint moments to changes in walking speed and body-weight-support are interdependent and vary across joints. , 2013, Journal of biomechanics.

[38]  David G. Lloyd,et al.  Individual muscle contributions to the swing phase of gait: An EMG-based forward dynamics modelling approach , 2007, Simul. Model. Pract. Theory.

[39]  M. Svehlik,et al.  Gait modifications to unload the hip in children with Legg–Calve–Perthes disease , 2012 .

[40]  F C T van der Helm,et al.  Inverse dynamics calculations during gait with restricted ground reaction force information from pressure insoles. , 2006, Gait & posture.

[41]  Xuan Zhang,et al.  Human lower extremity joint moment prediction: A wavelet neural network approach , 2014, Expert Syst. Appl..

[42]  Prasanth B. Nair,et al.  Statistical modelling of the whole human femur incorporating geometric and material properties. , 2010, Medical engineering & physics.

[43]  G. Bergmann,et al.  Loading of the knee joint during activities of daily living measured in vivo in five subjects. , 2010, Journal of biomechanics.

[44]  Jodie A. McClelland,et al.  193 A NOVEL REHABILITATION PARADIGM TO IMPROVE MOVEMENT SYMMETRY AND MAXIMIZE LONG-TERM OUTCOMES AFTER TOTAL KNEE ARTHROPLASTY , 2011 .

[45]  A. Leardini,et al.  Functional evaluation of patients treated with osteochondral allograft transplantation for post-traumatic ankle arthritis: one year follow-up. , 2013, Gait & posture.

[46]  Zhonglin Zhu,et al.  Construction of 3D human distal femoral surface models using a 3D statistical deformable model. , 2011, Journal of biomechanics.

[47]  A. Mündermann,et al.  Implications of increased medio-lateral trunk sway for ambulatory mechanics. , 2008, Journal of biomechanics.

[48]  Ling Wang,et al.  Feed forward artificial neural network to predict contact force at medial knee joint: Application to gait modification , 2014, Neurocomputing.

[49]  M. Cutkosky,et al.  Toe-in gait reduces the first peak knee adduction moment in patients with medial compartment knee osteoarthritis. , 2013, Journal of biomechanics.

[50]  William R Taylor,et al.  Tibio‐femoral loading during human gait and stair climbing , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[51]  Michael A Hunt,et al.  Sagittal plane joint loading is related to knee flexion in osteoarthritic gait. , 2013, Clinical biomechanics.

[52]  Gregg R. Klein,et al.  Pain Management and Accelerated Rehabilitation After Total Knee Arthroplasty , 2008 .