Modeling of active skeletal muscles: a 3D continuum approach incorporating multiple muscle interactions

Phenomenological Muscle Constitutive Model With Actin-Titin Binding for Simulating Active Stretching

The force produced by a muscle depends on its contractile history, yet human movement simulations typically employ muscle models that define the force-length relationship from measurements of fiber force during isometric contractions. In these muscle models, the total force-length curve can have a negative slope at fiber lengths greater than the fiber length at which peak isometric force is produced. This region of negative stiffness can cause numerical instability in simulations. Experiments have found that the steady-state force in a muscle fiber following active stretching is greater than the force produced during a purely isometric contraction. This behavior is called residual force enhancement. We present a constitutive model that exhibits force enhancement, implemented as a hyperelastic material in the febio finite element software. There is no consensus on the mechanisms responsible for force enhancement; we adopt the assumption that the passive fiber force depends on the sarcomere length at the instant that the muscle is activated above a threshold. We demonstrate the numerical stability of our model using an eigenvalue analysis and by simulating a muscle whose fibers are of different lengths. We then use a three-dimensional muscle geometry to verify the effect of force enhancement on the development of stress and the distribution of fiber lengths. Our proposed muscle material model is one of the few models available that exhibits force enhancement and is suitable for simulations of active lengthening. We provide our implementation in febio so that others can reproduce and extend our results.

Neural-driven activation of 3D muscle within a finite element framework: exploring applications in healthy and neurodegenerative simulations

This paper presents a novel computational framework for neural-driven finite element muscle models, with an application to amyotrophic lateral sclerosis (ALS). The multiscale neuromusculoskeletal (NMS) model incorporates physiologically accurate motor neurons, 3D muscle geometry, and muscle fiber recruitment. It successfully predicts healthy muscle force and tendon elongation and demonstrates a progressive decline in muscle force due to ALS, dropping from 203 N (healthy) to 155 N (120 days after ALS onset). This approach represents a preliminary step towards developing integrated neural and musculoskeletal simulations to enhance our understanding of neurodegenerative and neurodevelopmental conditions through predictive NMS models.

Emerging Innovations in Preoperative Planning and Motion Analysis in Orthopedic Surgery

In recent years, preoperative planning has undergone significant advancements, with a dual focus: improving the accuracy of implant placement and enhancing the prediction of functional outcomes. These breakthroughs have been made possible through the development of advanced processing methods for 3D preoperative images. These methods not only offer novel visualization techniques but can also be seamlessly integrated into computer-aided design models. Additionally, the refinement of motion capture systems has played a pivotal role in this progress. These "markerless" systems are more straightforward to implement and facilitate easier data analysis. Simultaneously, the emergence of machine learning algorithms, utilizing artificial intelligence, has enabled the amalgamation of anatomical and functional data, leading to highly personalized preoperative plans for patients. The shift in preoperative planning from 2D towards 3D, from static to dynamic, is closely linked to technological advances, which will be described in this instructional review. Finally, the concept of 4D planning, encompassing periarticular soft tissues, will be introduced as a forward-looking development in the field of orthopedic surgery.

Determining a musculoskeletal system's pre-stretched state using continuum-mechanical forward modelling and joint range optimization

The subject-specific range of motion (RoM) of a musculoskeletal joint system is balanced by pre-tension levels of individual muscles, which affects their contraction capability. Such an inherent pre-tension or pre-stretch of muscles is not measureable with in vivo experiments. Using a 3D continuum mechanical forward simulation approach for motion analysis of the musculoskeletal system of the forearm with 3 flexor and 2 extensor muscles, we developed an optimization process to determine the muscle fibre pre-stretches for an initial arm position, which is given human dataset. We used RoM values of a healthy person to balance the motion in extension and flexion. The performed sensitivity study shows that the fibre pre-stretches of the m. brachialis, m. biceps brachii and m. triceps brachii with 91 % dominate the objective flexion ratio, while m. brachiradialis and m. anconeus amount 7.8 % and 1.2 % . Within the multi-dimensional space of the surrogate model, 3D sub-spaces of primary variables, namely the dominant muscles and the global objective, flexion ratio, exhibit a path of optimal solutions. Within this optimal path, the muscle fibre pre-stretch of two flexors demonstrate a negative correlation, while, in contrast, the primary extensor, m. triceps brachii correlates positively to each of the flexors. Comparing the global optimum with four other designs along the optimal path, we saw large deviations, e.g., up to 15∘ in motion and up to 40% in muscle force. This underlines the importance of accurate determination of fibre pre-stretch in muscles, especially, their role in pathological muscular disorders and surgical applications such as free muscle or tendon transfer.

Finite Element Model of the Shoulder with Active Rotator Cuff Muscles: Application to Wheelchair Propulsion

The rotator cuff is prone to injury, remarkably so for manual wheelchair users. To understand its pathomechanisms, finite element models incorporating three-dimensional activated muscles are needed to predict soft tissue strains during given tasks. This study aimed to develop such a model to understand pathomechanisms associated with wheelchair propulsion. We developed an active muscle model associating a passive fiber-reinforced isotropic matrix with an activation law linking calcium ion concentration to tissue tension. This model was first evaluated against known physiological muscle behavior; then used to activate the rotator cuff during a wheelchair propulsion cycle. Here, experimental kinematics and electromyography data was used to drive a shoulder finite element model. Finally, we evaluated the importance of muscle activation by comparing the results of activated and non-activated rotator cuff muscles during both propulsion and isometric contractions. Qualitatively, the muscle constitutive law reasonably reproduced the classical Hill model force-length curve and the behavior of a transversally loaded muscle. During wheelchair propulsion, the deformation and fiber stretch of the supraspinatus muscle-tendon unit pointed towards the possibility for this tendon to develop tendinosis due to the multiaxial loading imposed by the kinematics of propulsion. Finally, differences in local stretch and positions of the lines of action between activated and non-activated models were only observed at activation levels higher than 30%. Our novel finite element model with active muscles is a promising tool for understanding the pathomechanisms of the rotator cuff for various dynamic tasks, especially those with high muscle activation levels.

Development of a biofidelic computational model of human pelvis for predicting biomechanical responses and pelvic fractures

BACKGROUND AND OBJECTIVE

The pelvis, a crucial structure for human locomotion, is susceptible to injuries resulting in significant morbidity and disability. This study aims to introduce and validate a biofidelic computational pelvis model, enhancing our understanding of pelvis injury mechanisms under lateral loading conditions.

METHODS

The Finite Element (FE) pelvic model, representing a mid-sized male, was developed with variable cortical thickness in pelvis bones. Material properties were determined through a synthesis of existing constitutive models, parametric studies, and multiple validations. Comprehensive validation included various tests, such as load-displacement assessments of sacroiliac joints, quasi-static and dynamic lateral compression on the acetabulum, dynamic side impacts on the acetabulum and iliac wing using defleshed pelvis, and lateral impacts by a rigid plate on the full body's pelvis region.

RESULTS

Simulation results demonstrated a reasonable correlation between the pelvis model's overall response and cadaveric testing data. Predicted fracture patterns of the isolated pelvis exhibited fair agreement with experimental results.

CONCLUSIONS

This study introduces a credible computational model, providing valuable biomechanical insights into the pelvis' response under diverse lateral loading conditions and fracture patterns. The work establishes a robust framework for developing and enhancing the biofidelity of pelvis FE models through a multi-level validation approach, stimulating further research in modeling, validation, and experimental studies related to pelvic injuries. The findings are expected to offer critical perspectives for predicting, preventing, and mitigating pelvic injuries from vehicular accidents, contributing to advancements in clinical research on medical treatments for pelvic fractures.

A Biomechanical Simulation of Forearm Flexion Using the Finite Element Approach

Upper limb movement is vital in daily life. A biomechanical simulation of the forearm with consideration of the physiological characteristics of the muscles is instrumental in gaining deeper insights into the upper limb motion mechanisms. In this study, we established a finite element model of the forearm, including the radius, biceps brachii, and tendons. We simulated the motion of the forearm resulting from the contraction of the biceps brachii by using a Hill-type transversely isotropic hyperelastic muscle model. We adjusted the contraction velocity of the biceps brachii muscle in the simulation and found that a slower muscle contraction velocity facilitated forearm flexion. Then, we changed the percentage of fast-twitch fibers, the maximum muscle strength, and the neural excitation values of the biceps brachii muscle to investigate the forearm flexion of elderly individuals. Our results indicated that reduced fast-twitch fiber percentage, maximum muscle strength, and neural excitation contributed to the decline in forearm motion capability in elderly individuals. Additionally, there is a threshold for neural excitation, below which, motion capability sharply declines. Our model aids in understanding the role of the biceps brachii in forearm flexion and identifying the causes of upper limb movement disorders, which is able to provide guidance for enhancing upper limb performance.

Development and verification of a physiologically motivated internal controller for the open-source extended Hill-type muscle model in LS-DYNA

Nowadays, active human body models are becoming essential tools for the development of integrated occupant safety systems. However, their broad application in industry and research is limited due to the complexity of incorporated muscle controllers, the long simulation runtime, and the non-regular use of physiological motor control approaches. The purpose of this study is to address the challenges in all indicated directions by implementing a muscle controller with several physiologically inspired control strategies into an open-source extended Hill-type muscle model formulated as LS-DYNA user-defined umat41 subroutine written in the Fortran programming language. This results in increased usability, runtime performance and physiological accuracy compared to the standard muscle material existing in LS-DYNA. The proposed controller code is verified with extensive experimental data that include findings for arm muscles, the cervical spine region, and the whole body. Selected verification experiments cover three different muscle activation situations: (1) passive state, (2) open-loop and closed-loop muscle activation, and (3) reflexive behaviour. Two whole body finite element models, the 50th percentile female VIVA OpenHBM and the 50th percentile male THUMS v5, are used for simulations, complemented by the simplified arm model extracted from the 50th percentile male THUMS v3. The obtained results are evaluated additionally with the CORrelation and Analysis methodology and the mean squared error method, showing good to excellent biofidelity and sufficient agreement with the experimental data. It was shown additionally how the integrated controller allows simplified mimicking of the movements for similar musculoskeletal models using the parameters transfer method. Furthermore, the Hill-type muscle model presented in this paper shows better kinematic behaviour even in the passive case compared to the existing one in LS-DYNA due to its improved damping and elastic properties. These findings provide a solid evidence base motivating the application of the enhanced muscle material with the internal controller in future studies with Active Human Body Models under different loading conditions.