用于髋关节结构性疾病研究的肌肉骨骼建模和运动模拟:方法和应用范围综述

Margaret S. Harrington, Stefania D. F. Di Leo, Courtney A. Hlady, Timothy A. Burkhart
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摘要

肌肉骨骼建模是一种强大的工具,可量化通常无法在体内测量的生物力学因素,如髋关节接触力和深层肌肉激活。本综述旨在总结当前髋关节结构紊乱研究中的建模和模拟方法,并评估模型验证实践和研究的可重复性。我们检索了 MEDLINE 和 Web of Science,以确定与使用肌肉骨骼模型研究结构性髋关节疾病(即涉及骨盆、股骨或两者的骨骼异常)有关的文献。共纳入 47 篇文章进行分析。这些研究或比较了多种建模方法,或采用单一建模工作流程来回答研究问题。总体而言,按参与者人体测量学比例缩放的通用模型与附加特定患者几何特征的模型在输出结果上存在差异;不过,通用模型在应用研究中最常用。对模型验证进行评估的 11 项研究仅使用了定性方法。在数据收集、数据处理和建模方法方面也存在很大的差异和报告不足。研究发现了肌肉骨骼建模在模型开发、验证和运动模拟过程中的常见假设,这些假设在评估建模预测对髋关节结构性疾病患者的临床适用性时非常重要。通用模型和患者特异性模型的输出结果之间存在差异,但患者特异性模型是否更准确仍是未知数。需要增加数据收集、信号处理和建模方法报告的透明度,以提高研究的可重复性,更好地评估建模结果。
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Musculoskeletal Modeling and Movement Simulation for Structural Hip Disorder Research: A Scoping Review of Methods and Applications
Musculoskeletal modeling is a powerful tool to quantify biomechanical factors typically not feasible to measure in vivo, such as hip contact forces and deep muscle activations. The purposes of this review were to summarize current modeling and simulation methods in structural hip disorder research and evaluate model validation practices and study reproducibility. MEDLINE and Web of Science were searched to identify literature relating to the use of musculoskeletal models to investigate structural hip disorders (i.e., involving a bony abnormality of the pelvis, femur, or both). Forty-seven articles were included for analysis. Studies either compared multiple modeling methods or applied a single modeling workflow to answer a research question. Overall, differences in outputs were shown between generic models scaled to participants’ anthropometrics and models with additional patient-specific geometry; however, generic models were most commonly used in application studies. The 11 studies that assessed model validation used qualitative approaches only. There was also wide variability and under-reporting of data collection, data processing, and modeling methods. Common assumptions made in musculoskeletal modeling during the model development, validation, and movement simulations were identified that are important to consider when evaluating the clinical applicability of modeling predictions in patients with structural hip disorders. Differences between generic and patient-specific model outputs exist; however, whether the patient-specific models are more accurate is still unknown. Increased transparency in reporting of data collection, signal processing, and modeling methods is needed to increase study reproducibility and allow for better assessment of modeling results.
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