[Numerical simulation in musculoskeletal biomechanics : Application perspectives and possibilities]. / Numerische Simulation in der muskuloskelettalen Biomechanik : Anwendungsperspektiven und Möglichkeiten.

BACKGROUND: Computational research methods, such as finite element analysis (FEA) and musculoskeletal multi-body simulation (MBS), are important in musculoskeletal biomechanics because they enable a better understanding of the mechanics of the musculoskeletal system, as well as the development and evaluation of orthopaedic implants. These methods are used to analyze clinically relevant issues in various anatomical regions, such as the hip, knee, shoulder joints and spine. Preoperative simulation can improve surgical planning in orthopaedics and predict individual results. EXAMPLES FROM PRACTICE: In this article, the methods of FE analysis and MBS are explained using two practical examples, and the activities of the "Numerical Simulation" cluster of the "Musculoskeletal Biomechanics Research Network (MSB-NET)" are presented in more detail. An outlook classifies numerical simulation in the age of artificial intelligence and draws attention to the relevance of simulation in the (re)approval of implants.

A sensorimotor enhanced neuromusculoskeletal model for simulating postural control of upright standing.

The human's upright standing is a complex control process that is not yet fully understood. Postural control models can provide insights into the body's internal control processes of balance behavior. Using physiologically plausible models can also help explaining pathophysiological motion behavior. In this paper, we introduce a neuromusculoskeletal postural control model using sensor feedback consisting of somatosensory, vestibular and visual information. The sagittal plane model was restricted to effectively six degrees of freedom and consisted of nine muscles per leg. Physiologically plausible neural delays were considered for balance control. We applied forward dynamic simulations and a single shooting approach to generate healthy reactive balance behavior during quiet and perturbed upright standing. Control parameters were optimized to minimize muscle effort. We showed that our model is capable of fulfilling the applied tasks successfully. We observed joint angles and ranges of motion in physiologically plausible ranges and comparable to experimental data. This model represents the starting point for subsequent simulations of pathophysiological postural control behavior.

Enhancing the Design of Experiments on the Fatigue Life Characterisation of Fibre-Reinforced Plastics by Incorporating Artificial Neural Networks.

Fatigue life testing is a complex and costly matter, especially in the case of fibre-reinforced thermoplastics, where other parameters in addition to force alone must be taken into account. The number of tests required therefore increases significantly, especially if the influence of different fibre orientations is to be taken into account. It is therefore important to gain the greatest possible amount of knowledge from the limited number of available tests. In order to achieve this, this study aims to utilise adaptive sampling, which is used in numerous areas of computational engineering, for the design of experiments on fatigue life testing. Artificial neural networks (ANNs) are therefore trained on data for the short-fibre-reinforced material PBT GF30, and their areas of greatest model uncertainty are queried. This was undertaken with ANNs from various numbers of hidden layers, which were analysed for their performance. The ideal case turned out to be four hidden layers, for which a squared error as small as 1 × 10-3 was recorded. Locally resolved, the ANN was used to identify the region of greatest uncertainty for samples of vertical orientation and small numbers of cycles. With information such as this, additional data can be obtained in such uncertain regions in order to improve the model prediction-almost halving the recorded error to only 0.55 × 10-3. In this way, a model of comparable value can be found with less experimental effort, or a model of better quality can be set up with the same experimental effort.

Assessment of the Suitability of Selected Linear Actuators for the Implementation of the Load-Adaptive Biological Principle of Redundant Motion Generation.

The load-adaptive behavior of the muscles in the human musculoskeletal system offers great potential for minimizing resource and energy requirements in many technical systems, especially in drive technology and robotics. However, the lack of knowledge about suitable technical linear actuators that can reproduce the load-adaptive behavior of biological muscles in technology is a major reason for the lack of successful implementation of this biological principle. In this paper, therefore, the different types of linear actuators are investigated. The focus is particularly on artificial muscles and rope pulls. The study is based on literature, on the one hand, and on two physical demonstrators in the form of articulated robots, on the other hand. The studies show that ropes are currently the best way to imitate the load-adaptive behavior of the biological model in technology. This is especially illustrated in the context of this paper by the discussion of different advantages and disadvantages of the technical linear actuators, where ropes, among other things, have a good mechanical and control behavior, which is very advantageous for use in an adaptive system. Finally, the next steps for future research are outlined to conclude how ropes can be used as linear actuators to transfer load-adaptive lightweight design into technical applications.

A Literature Review on the Development and Creation of Digital Twins, Cyber-Physical Systems, and Product-Service Systems.

Digital Twins offer vast potential, yet many companies, particularly small and medium-sized enterprises, hesitate to implement them. This hesitation stems partly from the challenges posed by the interdisciplinary nature of creating Digital Twins. To address these challenges, this paper explores systematic approaches for the development and creation of Digital Twins, drawing on relevant methods and approaches presented in the literature. Conducting a systematic literature review, we delve into the development of Digital Twins while also considering analogous concepts, such as Cyber-Physical Systems and Product-Service Systems. The compiled literature is categorised into three main sections: holistic approaches, architecture, and models. Each category encompasses various subcategories, all of which are detailed in this paper. Through this comprehensive review, we discuss the findings and identify research gaps, shedding light on the current state of knowledge in the field of Digital Twin development. This paper aims to provide valuable insights for practitioners and researchers alike, guiding them in navigating the complexities associated with the implementation of Digital Twins.

The Determination of Assistance-as-Needed Support by an Ankle-Foot Orthosis for Patients with Foot Drop.

Patients who suffer from foot drop have impaired gait pattern functions and a higher risk of stumbling and falling. Therefore, they are usually treated with an assistive device, a so-called ankle-foot orthosis. The support of the orthosis should be in accordance with the motor requirements of the patient and should only be provided when needed, which is referred to as assistance-as-needed. Thus, in this publication, an approach is presented to determine the assistance-as-needed support using musculoskeletal human models. Based on motion capture recordings of multiple subjects performing gaits at different speeds, a parameter study varying the optimal force of a reserve actuator representing the ankle-foot orthosis added in the musculoskeletal simulation is conducted. The results show the dependency of the simulation results on the selected optimal force of the reserve actuator but with a possible identification of the assistance-as-needed support required from the ankle-foot orthosis. The required increase in support due to the increasing severity of foot drop is especially demonstrated with the approach. With this approach, information for the required support of individual subjects can be gathered, which can further be used to derive the design of an ankle-foot orthosis that optimally assists the subjects.

Fatigue Behaviour and Its Effect on the Residual Strength of Long-Fibre-Reinforced Thermoplastic PP LGF30.

It is undeniable that mechanical properties, such as the stiffness or residual strength of fibre-reinforced thermoplastics, are adversely affected by fatigue damage caused by cyclic loading. In order to quantify and predict this damage influence, a calculation approach was developed in the past for the subgroup of short-fibre-reinforced thermoplastics. In order to test and expand the applicability of this approach to the field of long-fibre-reinforced thermoplastics, the decrease in mechanical properties is investigated experimentally in this paper using PP LGF30, propylene reinforced with long glass fibres, as an example. The paper describes both the fatigue behaviour and the residual strength of the material after fatigue damage. A decrease in the residual strength of up to about 35% could be recorded. The paper also presents a modelling approach that predicts the orientation-dependent fatigue strength of the material, and furthermore allows for the calculation of its residual strength as a function of fatigue damage. The novelty of the contribution lies in the continuous modelling of fatigue behaviour for arbitrary oriented samples of long-fibre-reinforced thermoplastics and also in the prediction of its residual strength depending on previously induced fatigue damage.

Methods for integrating postural control into biomechanical human simulations: a systematic review.

Understanding of the human body's internal processes to maintain balance is fundamental to simulate postural control behaviour. The body uses multiple sensory systems' information to obtain a reliable estimate about the current body state. This information is used to control the reactive behaviour to maintain balance. To predict a certain motion behaviour with knowledge of the muscle forces, forward dynamic simulations of biomechanical human models can be utilized. We aim to use predictive postural control simulations to give therapy recommendations to patients suffering from postural disorders in the future. It is important to know which types of modelling approaches already exist to apply such predictive forward dynamic simulations. Current literature provides different models that aim to simulate human postural control. We conducted a systematic literature research to identify the different approaches of postural control models. The different approaches are discussed regarding their applied biomechanical models, sensory representation, sensory integration, and control methods in standing and gait simulations. We searched on Scopus, Web of Science and PubMed using a search string, scanned 1253 records, and found 102 studies to be eligible for inclusion. The included studies use different ways for sensory representation and integration, although underlying neural processes still remain unclear. We found that for postural control optimal control methods like linear quadratic regulators and model predictive control methods are used less, when models' level of details is increasing, and nonlinearities become more important. Considering musculoskeletal models, reflex-based and PD controllers are mainly applied and show promising results, as they aim to create human-like motion behaviour considering physiological processes.

Method for Using IMU-Based Experimental Motion Data in BVH Format for Musculoskeletal Simulations via OpenSim.

Biomechanical simulation allows for in silico estimations of biomechanical parameters such as muscle, joint and ligament forces. Experimental kinematic measurements are a prerequisite for musculoskeletal simulations using the inverse kinematics approach. Marker-based optical motion capture systems are frequently used to collect this motion data. As an alternative, IMU-based motion capture systems can be used. These systems allow flexible motion collection without nearly any restriction regarding the environment. However, one limitation with these systems is that there is no universal way to transfer IMU data from arbitrary full-body IMU measurement systems into musculoskeletal simulation software such as OpenSim. Thus, the objective of this study was to enable the transfer of collected motion data, stored as a BVH file, to OpenSim 4.4 to visualize and analyse the motion using musculoskeletal models. By using the concept of virtual markers, the motion saved in the BVH file is transferred to a musculoskeletal model. An experimental study with three participants was conducted to verify our method's performance. Results show that the present method is capable of (1) transferring body dimensions saved in the BVH file to a generic musculoskeletal model and (2) correctly transferring the motion data saved in the BVH file to a musculoskeletal model in OpenSim 4.4.

Design and Additive Manufacturing of a Passive Ankle-Foot Orthosis Incorporating Material Characterization for Fiber-Reinforced PETG-CF15.

The individualization of patient-specific ankle joint orthoses is becoming increasingly important and can be ideally realized by means of additive manufacturing. However, currently, there are no functional additively manufactured fiber-reinforced products that are used in the field of orthopedic treatment. In this paper, an approach as to how additively manufactured orthopedic products can be designed and produced quickly and flexibly in the future is presented. This is demonstrated using the example of a solid ankle-foot orthosis. For this purpose, test results on PETG-CF15, which were determined in a previous work, were integrated into a material map for an FEA simulation. Therewith, the question can be answered as to whether production parameters that were determined at the test specimen level can also be adapted to real, usable components. Furthermore, gait recordings were used as loading conditions to obtain exact results for the final product. In order to perfectly adapt the design of the splint to the user, a 3D scan of a foot was performed to obtain a perfect design space for topology optimization. This resulted in a patient-specific and stiffness-optimized product. Subsequently, it was demonstrated that the orthosis could be manufactured using fused layer modelling. Finally, a comparison between the conventional design and the consideration of AM-specific properties was made. On this basis, it can be stated that the wearing comfort of the patient-specific design is very good, but the tightening of the splint still needs to be improved.

Subject-specific tribo-contact conditions in total knee replacements: a simulation framework across scales.

Fundamental knowledge about in vivo kinematics and contact conditions at the articulating interfaces of total knee replacements are essential for predicting and optimizing their behavior and durability. However, the prevailing motions and contact stresses in total knee replacements cannot be precisely determined using conventional in vivo measurement methods. In silico modeling, in turn, allows for a prediction of the loads, velocities, deformations, stress, and lubrication conditions across the scales during gait. Within the scope of this paper, we therefore combine musculoskeletal modeling with tribo-contact modeling. In the first step, we compute contact forces and sliding velocities by means of inverse dynamics approach and force-dependent kinematic solver based upon experimental gait data, revealing contact forces during healthy/physiological gait of young subjects. In a second step, the derived data are employed as input data for an elastohydrodynamic model based upon the finite element method full-system approach taking into account elastic deformation, the synovial fluid's hydrodynamics as well as mixed lubrication to predict and discuss the subject-specific pressure and lubrication conditions.

Exploring the importance of a usable and emotional product design from the user's perspective.

Usability and emotionality are important components of user experience. However, an equal consideration of both constructs in product design is not always possible due to sometimes competitive objectives. In order to foster a user-oriented design decision in such conflicting situations, this paper examines the general importance of both constructs and their dimensions from the user's perspective while taking into account socio-demographic variables. Examination was realised by conducting a product independent anonymous online survey (n = 130). The findings confirm that both constructs are important, yet in a direct comparison, usability is perceived as more important than emotionality. Taking selected dimensions of both constructs into account, an intuitive, easy and learnable usage, suitability for the user's task and freedom from impairment are particularly important in terms of usability. An aesthetic and pleasurable product design as well as originality is essential in terms of emotionality.Practitioner summary: This paper aims for supporting user-oriented design decisions in the context of conflicting objectives occurring in the consideration of usability and emotionality in product design. The conducted survey (n = 130) revealed usability as perceived more important than emotionality. Usability may thus be prioritised within conflicting design decisions.Abbreviations: DFG: German Research Foundation; e.g.: for example; GESIS: Leibniz Institute for the Social Sciences; m: metric; M: Mean; n: number of participants; n: nominal; o: ordinal; p level: level of statistical significance; RQ: Research question; r: correlation coefficient; V: Cramer's V; χ2: Chi-square.

Modelling the interaction between wearable assistive devices and digital human models-A systematic review.

Exoskeletons, orthoses, exosuits, assisting robots and such devices referred to as wearable assistive devices are devices designed to augment or protect the human body by applying and transmitting force. Due to the problems concerning cost- and time-consuming user tests, in addition to the possibility to test different configurations of a device, the avoidance of a prototype and many more advantages, digital human models become more and more popular for evaluating the effects of wearable assistive devices on humans. The key indicator for the efficiency of assistance is the interface between device and human, consisting mainly of the soft biological tissue. However, the soft biological tissue is mostly missing in digital human models due to their rigid body dynamics. Therefore, this systematic review aims to identify interaction modelling approaches between wearable assistive devices and digital human models and especially to study how the soft biological tissue is considered in the simulation. The review revealed four interaction modelling approaches, which differ in their accuracy to recreate the occurring interactions in reality. Furthermore, within these approaches there are some incorporating the appearing relative motion between device and human body due to the soft biological tissue in the simulation. The influence of the soft biological tissue on the force transmission due to energy absorption on the other side is not considered in any publication yet. Therefore, the development of an approach to integrate the viscoelastic behaviour of soft biological tissue in the digital human models could improve the design of the wearable assistive devices and thus increase its efficiency and efficacy.

Inner marginal strength of CAD/CAM materials is not affected by machining protocol.

PURPOSE: Here we aimed to compare two machining strategies regarding the marginal strength of CAD/CAM materials using a hoop-strength test in model sphero-cylindrical dental crowns, coupled with finite element analysis. MATERIALS AND METHODS: Five CAD/CAM materials indicated for single posterior crowns were selected, including a lithium disilicate (IPS e.max® CAD), a lithium (di)silicate (Suprinity® PC), a polymer-infiltrated ceramic scaffold (Enamic®), and two indirect resin composites (Grandio® Blocs and Lava™ Ultimate). A sphero-cylindrical model crown was built on CAD Software onto a geometrical abutment and machined using a Cerec MC XL system according to the two available protocols: rough-fast and fine-slow. Specimens were fractured using a novel hoop-strength test and analyzed using the finite element method to obtain the inner marginal strength. Data were evaluated using Weibull statistics. RESULTS: Machining strategy did not affect the marginal strength of any restorative material tested here. Ceramic materials showed a higher density of chippings in the outer margin, but this did not reduce inner marginal strength. IPS e.max® CAD showed the statistically highest marginal strength, and Enamic® and Lava™ Ultimate were the lowest. Grandio® Blocs showed higher performance than Suprinity® PC. CONCLUSIONS: The rough-fast machining strategy available in Cerec MC XL does not degrade the marginal strength of the evaluated CAD/CAD materials when compared to its fine-fast machining strategy. Depending on the material, resin composites have the potential to perform better than some glass-ceramic materials.

Amorphous Carbon Coatings for Total Knee Replacements-Part II: Tribological Behavior.

Diamond-like carbon coatings may decrease implant wear, therefore, they are helping to reduce aseptic loosening and increase service life of total knee arthroplasties (TKAs). This two-part study addresses the development of such coatings for ultrahigh molecular weight polyethylene (UHMWPE) tibial inlays as well as cobalt-chromium-molybdenum (CoCr) and titanium (Ti64) alloy femoral components. While the deposition of a pure (a-C:H) and tungsten-doped hydrogen-containing amorphous carbon coating (a-C:H:W) as well as the detailed characterization of mechanical and adhesion properties were the subject of Part I, the tribological behavior is studied in Part II. Pin-on-disk tests are performed under artificial synovial fluid lubrication. Numerical elastohydrodynamic lubrication modeling is used to show the representability of contact conditions for TKAs and to assess the influence of coatings on lubrication conditions. The wear behavior is characterized by means of light and laser scanning microscopy, Raman spectroscopy, scanning electron microscopy and particle analyses. Although the coating leads to an increase in friction due to the considerably higher roughness, especially the UHMWPE wear is significantly reduced up to a factor of 49% (CoCr) and 77% (Ti64). Thereby, the coating shows continuous wear and no sudden failure or spallation of larger wear particles. This demonstrated the great potential of amorphous carbon coatings for knee replacements.

Amorphous Carbon Coatings for Total Knee Replacements-Part I: Deposition, Cytocompatibility, Chemical and Mechanical Properties.

Diamond-like carbon (DLC) coatings have the potential to reduce implant wear and thus to contribute to avoiding premature failure and increase service life of total knee replacements (TKAs). This two-part study addresses the development of such coatings for ultrahigh molecular weight polyethylene (UHMWPE) tibial inlays as well as cobalt-chromium-molybdenum (CoCr) and titanium (Ti64) alloy femoral components. While a detailed characterization of the tribological behavior is the subject of part II, part I focusses on the deposition of pure (a-C:H) and tungsten-doped hydrogen-containing amorphous carbon coatings (a-C:H:W) and the detailed characterization of their chemical, cytological, mechanical and adhesion behavior. The coatings are fabricated by physical vapor deposition (PVD) and display typical DLC morphology and composition, as verified by focused ion beam scanning electron microscopy and Raman spectroscopy. Their roughness is higher than that of the plain substrates. Initial screening with contact angle and surface tension as well as in vitro testing by indirect and direct application indicate favorable cytocompatibility. The DLC coatings feature excellent mechanical properties with a substantial enhancement of indentation hardness and elastic modulus ratios. The adhesion of the coatings as determined in modified scratch tests can be considered as sufficient for the use in TKAs.

Simplifying Computer Aided Ergonomics: A User-Product Interaction-Modeling Framework in CAD Based on a Taxonomy of Elementary Affordances.

OCCUPATIONAL APPLICATIONSThis contribution provides a framework for modeling user-product interactions (in CAD) for in-depth ergonomic analysis of product design, using digital human models. The framework aims to be applicable to a wide range of different products while being suitable for designers - especially those who do not have specialized ergonomic expertise or training in human behavior - by providing an intuitive, standardized, and time-efficient modeling procedure. The framework contains 31 elementary affordances, which describe mechanical dependencies between product geometries and human end effectors. These elementary affordances serve as a tool for interaction modeling. Additionally, the paper provides a taxonomy of elementary affordances, which can be used to formalize / abstract the nature of user-product interactions and to describe them as elementary affordances. Furthermore, an implementation of the interaction-modeling framework is presented in a CAD environment and provides an example of how the framework could be used in terms of a computer aided ergonomics tool.

TECHNICAL ABSTRACTBackground Digital human models (DHM) have not yet reached their full potential for proactive virtual assessment of ergonomics in engineering and industrial design. Modeling the interaction between user and product often is time demanding, cumbersome, unstandardized, or embedded insufficiently in the computer aided engineering environment. Existing interaction-modeling frameworks either address the simulation of occupational processes, are limited to a specific use cases, or offer insufficient usability.Purpose We present a framework for interaction modeling, its methodic background, as well as its implementation. The framework aims to provide ergonomic analyses of product designs, while being suitable for designers who do not have specific ergonomic knowledge or training in human behavior.Methods To resolve these partly contradictable demands, we utilize affordances, which serve as a tool for interaction modeling. We hypothesize, that many interaction concepts existing in human technology interaction can be reduced to a relatively small set of elementary affordances. We developed a taxonomy of elementary affordances to deduce elementary affordances from empirical interaction data.Results We present the resulting taxonomy, as well as the resulting 31 elementary affordances, which describe mechanical dependencies between product geometries and human end effectors. The identified elementary affordances are implemented as affordance features in a CAD environment (Siemens NX) and result in an interaction-modeling framework. A brief application example regarding the functionalities of the framework is presented.Conclusions The introduced framework demonstrates how the integration of interaction modeling into the computer aided engineering environment can be achieved in a comprehensible and straightforward way. The resulting simplicity and accessibility may constitute one key factor to help exploit the potential of DHM simulation as a computer aided ergonomics tool in engineering and industrial design.

Exploring the lubrication mechanisms of synovial fluids for joint longevity - A perspective.

Synovial fluids are complex fluids responsible for the exceptional lubrication present in synovial joints. These fluids consist of various constituents, including hyaluronic acid, surface-active proteins (i.e., lubricin), surface-active phospholipids, as well as various other proteins such as human serum albumin and γ -globulin seric proteins, each of them playing an essential role in lubrication. Being the key to the most efficient biotribological systems, this article is intended to review the current understanding of the underlying lubrication mechanisms of the synovial fluids enables prospective usage in numerous applications, especially as a lubricant for hip and knee prosthetics in combatting osteoarthritis. Current research focuses on the determination of the role of proteins in prosthetic lubrication, optimal material combinations for prosthesis, and the effects of relevant physical variables in prosthetic lubrication. The characterization of prosthetic lubrication and wear mechanisms by synovial fluids represents a prominent challenge in tribological research, yet also an important hurdle to overcome towards optimal lubrication of articular prosthetics.

Structured ergonomic guidance in early design phases by analysing the user-product interaction.

Gathering information for an early, proactive integration of ergonomic user requirements is challenging due to the unstructured character of available knowledge. Knowledge acquisition and processing is therefore costly and time-consuming. This contribution presents and evaluates InProCo, an approach for structured ergonomic guidance that aims to improve accessibility and clarity of ergonomic requirements in early design phases by providing interaction-based ergonomic properties. InProCo reduces the complexity of gathering knowledge and provide a novel way to describe interactions. Within a three-stage evaluation process, a survey assessed standard interactions for completeness, the output given by the graphical user interface of the approach (GUI) was evaluated for correctness and the knowledge base was validated by comparing the approaches output with properties identified by participants within a one-day workshop. The results showed that there are enough predefined standard interactions, the output of the GUI is valid and the knowledge base contains high quality data. Practitioner Summary: InProCo is an approach that provides structured interaction-based ergonomic properties to improve accessibility and clarity of ergonomic requirements in early design phases. This contribution presents and evaluates InProCo building the prerequisite for further use in an industrial context.

Fringe Projection Profilometry in Production Metrology: A Multi-Scale Comparison in Sheet-Bulk Metal Forming.

Fringe projection profilometry in combination with other optical measuring technologies has established itself over the last decades as an essential complement to conventional, tactile measuring devices. The non-contact, holistic reconstruction of complex geometries within fractions of a second in conjunction with the lightweight and transportable sensor design open up many fields of application in production metrology. Furthermore, triangulation-based measuring principles feature good scalability, which has led to 3D scanners for various scale ranges. Innovative and modern production processes, such as sheet-bulk metal forming, thus, utilize fringe projection profilometry in many respects to monitor the process, quantify possible wear and improve production technology. Therefore, it is essential to identify the appropriate 3D scanner for each application and to properly evaluate the acquired data. Through precise knowledge of the measurement volume and the relative uncertainty with respect to the specimen and scanner position, adapted measurement strategies and integrated production concepts can be realized. Although there are extensive industrial standards and guidelines for the quantification of sensor performance, evaluation and tolerancing is mainly global and can, therefore, neither provide assistance in the correct, application-specific positioning and alignment of the sensor nor reflect the local characteristics within the measuring volume. Therefore, this article compares fringe projection systems across various scale ranges by positioning and scanning a calibrated sphere in a high resolution grid.