Prinold Joe A I, Masjedi Milad, Johnson Garth R, Bull Anthony M J
Department of Bioengineering, Imperial College London, London, UK.
Proc Inst Mech Eng H. 2013 Oct;227(10):1041-57. doi: 10.1177/0954411913492303. Epub 2013 Jul 12.
Musculoskeletal shoulder models allow non-invasive prediction of parameters that cannot be measured, particularly the loading applied to morphological structures and neurological control. This insight improves treatment and avoidance of pathology and performance evaluation and optimisation. A lack of appropriate validation and knowledge of model parameters' accuracy may cause reduced clinical success for these models. Instrumented implants have recently been used to validate musculoskeletal models, adding important information to the literature. This development along with increasing prevalence of shoulder models necessitates a fresh review of available models and their utility. The practical uses of models are described. Accuracy of model inputs, modelling techniques and model sensitivity is the main technical review undertaken. Collection and comparison of these parameters are vital to understanding disagreement between model outputs. Trends in shoulder modelling are highlighted: validation through instrumented prostheses, increasing openness and strictly constrained, optimised, measured kinematics. Future directions are recommended: validation through focus on model sub-sections, increased subject specificity with imaging techniques determining muscle and body segment parameters and through different scaling and kinematics optimisation approaches.
肌肉骨骼肩部模型能够对无法测量的参数进行无创预测，特别是施加于形态结构的负荷以及神经控制。这一见解有助于改善疾病治疗、预防以及性能评估与优化。缺乏适当的验证以及对模型参数准确性的了解，可能会导致这些模型在临床应用中成功率降低。最近，仪器植入物已被用于验证肌肉骨骼模型，为文献增添了重要信息。随着肩部模型的日益普及，这一进展使得有必要对现有模型及其效用进行重新审视。文中描述了模型的实际用途。主要的技术综述内容包括模型输入的准确性、建模技术以及模型敏感性。收集和比较这些参数对于理解模型输出之间的差异至关重要。文中强调了肩部建模的趋势：通过仪器化假体进行验证、提高开放性以及严格约束、优化和测量运动学。建议了未来的发展方向：通过关注模型子部分进行验证、利用成像技术确定肌肉和身体节段参数以提高个体特异性，以及采用不同的缩放和运动学优化方法。
