The Viability of a 3D Forward Dynamic Model of Walking as a Research Tool to Enhance Clinical Understanding of Gait Abnormalities

Forward dynamic models are powerful tools which, alongside clinical gait analysis, can be used to evaluate abnormal walking conditions in a controlled environment to gain insight into movement adaptation strategies. This study explored the feasibility of using forward dynamic simulation models of walking to enhance clinical understanding of the link between pathological conditions and human walking patterns.

A 3D, forward dynamic single leg model of walking was developed using kinematic pelvis drivers to allow the reproduction of the entire stance phase of normal walking. The model simulated normal walking for the last 60% of the stance phase of gait successfully, but was unable to reproduce normal walking immediately after heel strike. Increases in model complexity including a 3D knee and complex ground contact model have improved upon existing models in literature. The use of pelvis kinematic drivers was rejected, and the incorporation of a second leg was recommended to increase the clinical relevance of this model.

Rotational malunion of the tibia (RMT) is a condition in which the distal end of the tibia is rotated with respect to the proximal end, about the long axis of the bone, due to improper healing following severe tibial fracture. RMT has been associated with gait adaptations and linked to non-physiological joint loading and osteoarthritis (Eckhoff, 1994). To augment a clinical study of RMT, the single leg walking model was evaluated for use in modelling RMT during the last 60% of stance phase. The single leg model was sensitive to geometric changes similar to RMT values. In addition, the model indicated similar trends to those seen in clinical data.

A new method for the quantification of model sensitivity to input parameters was developed. Using this method, the simulations of running and walking were more sensitive to muscle model and joint stiffness and damping parameters than the range of values in literature. In addition, the sensitivity of many model parameters was greater than the clinical changes due to RMT. These results stress the importance of the measurement of subject specific model parameters, particularly in clinical populations.

The research presented here provides tools to enhance the potential of forward dynamic walking models to contribute to the clinical evaluation of gait pathology.

Year	Entry
2001	Anderson FC, Pandy MG. Static and dynamic optimization solutions for gait are practically equivalent. J Biomech. February 2001;34(2):153-161.
1992	Perry J. Gait Analysis: Normal and Pathological Function. Thorofare, NJ: SLACK Incorporated; 1992.
1996	Piazza SJ, Delp SL. The influence of muscles on knee flexion during the swing phase of gait. J Biomech. June 1996;29(6):723-733.
2001	Anderson FC, Pandy MG. Dynamic optimization of human walking. J Biomech Eng. October 2001;123(5):381-390.
1990	Pandy MG, Zajac FE, Sim E, Levine WS. An optimal control model for maximum-height human jumping. J Biomech. 1990;23(12):1185-1198.
1983	Wickiewicz TL, Roy RR, Powell PL, Edgerton VR. Muscle architecture of the human lower limb. Clin Orthop Relat Res. October 1983;179:275-283.
1957	Huxley AF. Muscle structure and theories of contraction. Prog Biophys Biophys Chem. 1957;7:255-318.
1991	Schipplein OD, Andriacchi TP. Interaction between active and passive knee stabilizers during level walking. J Orthop Res. January 1991;9(1):113-119.
1990	Yamaguchi GT. Performing whole-body simulations of gait with 3-D, dynamic musculoskeletal models. In: Winters JM, Woo SL-Y, eds. Multiple Muscle Systems: Biomechanics and Movement Organization. New York, NY: Springer-Verlag; 1990:663-679.
2000	Bauby CE, Kuo AD. Active control of lateral balance in human walking. J Biomech. November 2000;33(11):1433-1440.
1978	Crowninshield RD, Johnston RC, Andrews JG, Brand RA. A biomechanical investigation of the human hip. J Biomech. 1978;11(1-2):75-85.
1973	Seireg A, Arvikar RJ. A mathematical model for evaluation of forces in lower extremeties of the musculo-skeletal system. J Biomech. May 1973;6(3):313-326.
1993	Söderkvist I, Wedin P-Å. Determining the movements of the skeleton using well-configured markers. J Biomech. December 1993;26(12):1473-1477.
1976	Hatze H. The complete optimization of a human motion. Math Biosci. 1976;28(1-2):99-135.
1992	Pandy MG, Anderson FC, Hull DG. A parameter optimization approach for the optimal control of large-scale musculoskeletal systems. J Biomech Eng. November 1992;114(4):450-460.
1997	Gerritsen KGM. Computer Simulation of FES-Assisted Locomotion [PhD thesis]. Calgary, AB: University of Calgary; December 1997.
2003	Anderson FC, Pandy MG. Individual muscle contributions to support in normal walking. Gait Post. April 2003;17(2):159-169.
1995	Gerritsen KGM, van den Bogert AJ, Nigg BM. Direct dynamics simulation of the impact phase in heel-toe running. J Biomech. June 1995;28(6):661-668.
2001	Neptune RR, Kautz SA, Zajac FE. Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking. J Biomech. November 2001;34(11):1387-1398.
2000	Neptune RR, Wright IC, van den Bogert AJ. A method for numerical simulation of single limb ground contact events: application to heel-toe running. Comput Methods Biomech Biomed Eng. 2000;3(4):321-334.
1980	Onyshko S, Winter DA. A mathematical model for the dynamics of human locomotion. J Biomech. 1980;13(4):361-368.
1989	Zajac FE. Muscle and tendon: properties, models, scaling, and application to biomechanics and motor control. Crit Rev Biomed Eng. 1989;17(4):359-411.
1976	Markolf KL, Mensch JS, Amstutz HC. Stiffness and laxity of the knee: the contributions of the supporting structures: a quantitative in vitro study. J Bone Joint Surg. July 1976;58A(5):583-594.
1998	Wright IC. A Simulation Study of the Contribution of Several Factors to Ankle Sprain Susceptibility [PhD thesis]. Calgary, AB: University of Calgary; December 1998.
1978	Crowninshield RD. Use of optimization techniques to predict muscle forces. J Biomech Eng. May 1978;100(2):88-92.
1988	Chen J, Siegler S, Schneck CD. The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joint, II: flexibility characteristics. J Biomech Eng. November 1988;110(4):374-385.
1984	An KN, Kwak BM, Chao EY, Morrey BF. Determination of muscle and joint forces: a new technique to solve the indeterminate problem. J Biomech Eng. November 1984;106(4):364-367.
1967	Paul JP. Forces transmitted by joints in the human body. Proc Inst Mech Eng. 1967;181(pt 3J):8-15.
1993	Zajac FE. Muscle coordination of movement: a perspective. J Biomech. 1993;26(suppl 1):109-124.
1969	Clauser CE, McConville JT, Young JW. Weight, Volume, and Center of Mass of Segments of the Human Body. Wright-Patterson AFB, Ohio: Aerospace Medical Research Laboratory; August 1969. Report No. AFRL-TR-69-70.
1989	Kadaba MP, Ramakrishnan HK, Wootten ME, Gainey J, Gorton G, Cochran GVB. Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait. J Orthop Res. November 1989;7(6):849-860.
1999	Neptune RR. Optimization algorithm performance in determining optimal controls in human movement analyses. J Biomech Eng. April 1999;121(2):249-252.
1998	Neptune RR, Hull ML. Evaluation of performance criteria for simulation of submaximal steady-state cycling using a forward dynamic model. J Biomech Eng. June 1998;120(3):334-341.
2001	Maganaris CN. Force–length characteristics of in vivo human skeletal muscle. Acta Physiol Scand. August 2001;172(4):279-285.
1990	Yamaguchi GT, Zajac FE. Restoring unassisted natural gait to paraplegics via functional neuromuscular stimulation: a computer simulation study. IEEE Trans Biomed Eng. September 1990;37(9):886-902.
1938	Hill AV. The heat of shortening and the dynamic constants of muscle. Proc R Soc Lond B Biol Sci. October 10, 1938;126(843):136-195.
1990	Delp SL. Surgery Simulation: A Computer Graphics System to Analyze and Design Musculoskeletal Reconstructions of the Lower Limb [PhD thesis]. Stanford University; August 1990.
1995	Challis JH. A procedure for determining rigid body transformation parameters. J Biomech. June 1995;28(6):733-737.
1990	Scott SH, Winter DA. Internal forces at chronic running injury sites. Med Sci Sports Exer. June 1990;22(3):357-369.
1986	Brand RA, Pedersen DR, Friederich JA. The sensitivity of muscle force predictions to changes in physiologic cross-sectional area. J Biomech. 1986;19(8):589-596.
1982	Brand RA, Crowninshield RD, Wittstock CE, Pedersen DR, Clark CR, van Krieken FM. A model of lower extremity muscular anatomy. J Biomech Eng. November 1982;104(4):304-310.
1997	Raasch CC, Zajac FE, Ma B, Levine WS. Muscle coordination of maximum-speed pedaling. J Biomech. June 1997;30(6):595-602.
1994	van den Bogert AJ, Smith GD, Nigg BM. In vivo determination of the anatomical axes of the ankle joint complex: an optimization approach. J Biomech. December 1994;27(12):1477-1488.
1989	White SC, Yack HJ, Winter DA. A three-dimensional musculoskeletal model for gait analysis: anatomical variability estimates. J Biomech. 1989;22(8-9):885-893.
2002	Zajac FE, Neptune RR, Kautz SA. Biomechanics and muscle coordination of human walking, I: introduction to concepts, power transfer, dynamics and simulations. Gait Post. December 2002;16(3):215-232.
2003	Zajac FE, Neptune RR, Kautz SA. Biomechanics and muscle coordination of human walking, II: lessons from dynamical simulations and clinical implications. Gait Post. February 2003;17(1):1-17.
1990	Delp SL, Loan JP, Hoy MG, Zajac FE, Topp EL, Rosen JM. An interactive graphics-based model of the lower extremity to study orthopaedic surgical procedures. IEEE Trans Biomed Eng. 1990;37(8):757-767.
1995	Seidel GK, Marchinda DM, Dijkers M, Soutas-Little RW. Hip joint center location from palpable bony landmarks: a cadaver study. J Biomech. August 1995;28(8):995-998.
1987	Davy DT, Audu ML. A dynamic optimization technique for predicting muscle forces in the swing phase of gait. J Biomech. 1987;20(2):187-201.
1975	Seireg A, Arvikar RJ. The prediction of muscular load sharing and joint forces in the lower extremities during walking. J Biomech. March 1975;8(2):89-102.
1986	Bobbert MF, Huijing PA, van Ingen Schenau GJ. A model of the human triceps surae muscle-tendon complex applied to jumping. J Biomech. 1986;19(11):887-898.
1995	Cole GK. Loading of the Joints of the Lower Extremities During the Impact Phase in Running [PhD thesis]. Calgary, AB: University of Calgary; July 1995.
1981	Hatze H. A comprehensive model for human motion simulation and its application to the take-off phase of the long jump. J Biomech. 1981;14(3):135-142.
1996	Lloyd DG, Buchanan TS. A model of load sharing between muscles and soft tissues at the human knee during static tasks. J Biomech Eng. August 1996;118(3):367-376.
1990	Rugg SG, Gregor RJ, Mandelbaum BR, Chiu L. In vivo moment arm calculations at the ankle using magnetic resonance imaging (MRI). J Biomech. 1990;23(5):495-501.
1978	Hardt DE. Determining muscle forces in the leg during normal human walking: an application and evaluation of optimization methods. J Biomech Eng. May 1978;100(2):72-78.
1974	Penrod DD, Davy DT, Singh DP. An optimization approach to tendon force analysis. J Biomech. March 1974;7(2):123-129.
1990	Hoy MG, Zajac FE, Gordon ME. A musculoskeletal model of the human lower extremity: the effect of muscle, tendon, and moment arm on the moment-angle relationship of musculotendon actuators at the hip, knee, and ankle. J Biomech. 1990;23(2):157-169.
1981	Crowninshield RD, Brand RA. A physiologically based criterion of muscle force prediction in locomotion. J Biomech. 1981;14(11):793-801.
1988	Blankevoort L, Huiskes R, de Lange A. The envelope of passive knee joint motion. J Biomech. 1988;21(9):705-720.
2003	Thelen DG. Adjustment of muscle mechanics model parameters to simulate dynamic contractions in older adults. J Biomech Eng. February 2003;125(1):70-77.
1990	Pandy MG. An analytical framework for quantifying muscular action during human movement. In: Winters JM, Woo SL-Y, eds. Multiple Muscle Systems: Biomechanics and Movement Organization. New York, NY: Springer-Verlag; 1990:653-662.
1990	Friederich JA, Brand RA. Muscle fiber architecture in the human lower limb. J Biomech. 1990;23(1):91-95.
1981	Patriarco AG, Mann RW, Simon SR, Mansour JM. An evaluation of the approaches of optimization models in the prediction of muscle forces during human gait. J Biomech. 1981;14(8):513-525.
1990	Zajac FE, Winters JM. Modeling musculoskeletal movement systems: joint and body segmental dynamics, musculoskeletal actuation, and neuromuscular control. In: Winters JM, Woo SL-Y, eds. Multiple Muscle Systems: Biomechanics and Movement Organization. New York, NY: Springer-Verlag; 1990:121-148.
1994	Goffe WL, Ferrier GD, Rogers J. Global optimization of statistical functions with simulated annealing. J Econom. January–February 1994;60:65-99.
1988	Bean JC, Chaffin DB, Schultz AB. Biomechanical model calculation of muscle contraction forces: a double linear programming method. J Biomech. 1988;21(1):59-66.
1990	Winters JM. Hill-based muscle models: a systems engineering perspective. In: Winters JM, Woo SL-Y, eds. Multiple Muscle Systems: Biomechanics and Movement Organization. New York, NY: Springer-Verlag; 1990:69-93.
1993	Bergmann G, Graichen F, Rohlmann A. Hip joint loading during walking and running, measured in two patients. J Biomech. August 1993;26(8):969-990.
1995	Eng JJ, Winter DA. Kinetic analysis of the lower limbs during walking: what information can be gained from a three-dimensional model? J Biomech. June 1995;28(6):753-758.
1995	Delp SL, Loan JP. A graphics-based software system to develop and analyze models of musculoskeletal structures. Comput Biol Med. January 1995;25(1):21-34.
1999	Anderson FC III. A Dynamic Optimization Solution for a Complete Cycle of Normal Gait [PhD thesis]. University of Texas at Austin; December 1999.
1998	Sharma L, Hurwitz DE, Thonar EJ-MA, Sum JA, Lenz ME, Dunlop DD, Schnitzer TJ, Kirwan-Mellis G, Andriacchi TP. Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis. Arthritis Rheum. July 1998;41(7):1233-1240.

Year

Entry

2001

Anderson FC, Pandy MG. Static and dynamic optimization solutions for gait are practically equivalent. J Biomech. February 2001;34(2):153-161.

1992

Perry J. Gait Analysis: Normal and Pathological Function. Thorofare, NJ: SLACK Incorporated; 1992.

1996

Piazza SJ, Delp SL. The influence of muscles on knee flexion during the swing phase of gait. J Biomech. June 1996;29(6):723-733.

2001

Anderson FC, Pandy MG. Dynamic optimization of human walking. J Biomech Eng. October 2001;123(5):381-390.

1990

Pandy MG, Zajac FE, Sim E, Levine WS. An optimal control model for maximum-height human jumping. J Biomech. 1990;23(12):1185-1198.