轮椅推进的肌肉骨骼模型验证及其在最小化肩关节力方面的应用。

Validation of a musculoskeletal model of wheelchair propulsion and its application to minimizing shoulder joint forces.

作者信息

Dubowsky Sarah R, Rasmussen John, Sisto Sue Ann, Langrana Noshir A

机构信息

Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA.

出版信息

J Biomech. 2008 Oct 20;41(14):2981-8. doi: 10.1016/j.jbiomech.2008.07.032. Epub 2008 Sep 19.

Abstract

The majority of manual wheelchair users (MWUs) will inevitably develop some degree of shoulder pain over time. Previous research has suggested a link between the shoulder joint forces associated with the repetition of wheelchair (WC) propulsion and pain. The objective of this work is to present and validate a rigid-body musculoskeletal model of the upper limb for calculation of shoulder joint forces throughout WC propulsion. It is anticipated that when prescribing a WC, the use of a patient-specific computational model will aide in determining an axle placement in which shoulder joint forces are at a minimum, thus potentially delaying or reducing the shoulder pain that so many MWUs experience. During the validation experiment, 3 subjects (2 individuals with paraplegia and one able-bodied individual) propelled a WC at a self-selected speed, during which, kinematics, kinetics, and electromyography (EMG) activity were measured for the contact phase of 10 consecutive push strokes. The measured forces at the push rim and the 3-D propulsion kinematics drove the model, and the computationally calculated muscle activities were compared with the experimental muscle activities, resulting in an average mean absolute error (MAE) of 0.165. Further investigation of the shoulder joint forces throughout propulsion demonstrate the effect of axle placement on the magnitude of these forces. The present work serves to validate the patient-specific upper limb model for use as a prescriptive tool for fitting a subject to their WC. Minimizing joint forces from injury onset may prolong a MWU's pain-free way of life.

摘要

大多数手动轮椅使用者(MWUs)随着时间的推移不可避免地会出现一定程度的肩部疼痛。先前的研究表明,与轮椅(WC)推进动作重复相关的肩关节受力与疼痛之间存在联系。这项工作的目的是提出并验证一个上肢刚体肌肉骨骼模型,用于计算整个WC推进过程中的肩关节受力。预计在为患者开具WC处方时,使用针对患者的计算模型将有助于确定轴的放置位置,使肩关节受力最小,从而有可能延迟或减轻许多MWUs所经历的肩部疼痛。在验证实验中,3名受试者(2名截瘫患者和1名健全个体)以自行选择的速度推动WC,在此期间,对连续10次推击动作的接触阶段进行了运动学、动力学和肌电图(EMG)活动测量。在轮辋上测得的力和三维推进运动学驱动该模型,并将计算得出的肌肉活动与实验测得的肌肉活动进行比较,平均平均绝对误差(MAE)为0.165。对整个推进过程中肩关节受力的进一步研究表明了轴放置位置对这些力大小的影响。目前的工作旨在验证针对患者的上肢模型可作为为受试者适配WC的处方工具。从损伤开始就尽量减少关节受力可能会延长MWU无痛的生活方式。

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