A multibody simulation of the spine for objectification of biomechanical quantities after VBT: a proof of concept and description of baseline data.

PURPOSE: Vertebral Body Tethering (VBT), an alternative treatment for adolescent idiopathic scoliosis, shows satisfactory post-operative results. However, the biomechanical quantities and consequences after VBT surgery remain largely unknown. Therefore, the aim of this study is to analyze the spinal biomechanics during different motions using a multibody simulation approach. METHODS: The tether and intervertebral compression forces were simulated in a validated spine model during different physiological movements at different pre-tensions and screw positions, while considering the anatomical muscle and ligament properties. RESULTS: The simulations showed that an augmentation of the pre-tension and an alteration of the screw position have both significant impact on the intervertebral compression and tether forces. The forces also vary depending on the movement performed, with the highest tether forces measured during lateral bending. In the upright position, with a pre-tension of 200 N, the maximum compression force increases by up to 157% compared to the untethered maximum compression force. The screw position can lead to large differences in the distribution of forces in the spine. CONCLUSION: The biomechanical data provide a first impression of the forces that occur along the spine during various physiological movements and are consistent with published clinical data. Forces are not evenly distributed along the spine, with higher lumbar forces. The tether forces reach values during lateral bending that can potentially destroy the tether´s integrity and thus may explain the common post-operative complication, namely tether breakage. The results of the model can therefore have an impact on future directions for improved surgical VBT treatment.

Evaluation of Ride Comfort in a Railway Passenger Car Depending on a Change of Suspension Parameters.

Ride comfort for passengers remains a pressing topic. The level of comfort in a vehicle can influences passengers' preferences for a particular means of transport. The article aims to evaluate the influence of changes in suspension parameters on the ride comfort for passengers. The theoretical background includes a description of the applied method for a creating the virtual model of an investigated vehicle as well as the method of evaluating the ride comfort. The ride comfort of the vehicle is assessed based on the standard method, which involves calculating the mean comfort method, i.e., ride comfort index NMV in chosen points on a body floor. The NMV ride comfort index (Mean Comfort Standard Method) requires the input of acceleration signals in three directions. The rest of the article offers the results of simulation computations. The stiffness-damping parameters of the primary and secondary suspension systems were changed at three levels and the vehicle was run on the real track section. The ride index NMV was calculated for all three modifications of the suspension system in the chosen fifteen points of the body floor. It was found that lower values in the stiffness of the secondary suspension system lead to lower levels of ride comfort in the investigated railway passenger car; however, lower values in the stiffness-damping parameters of the primary suspension system did not decrease the levels of ride comfort as significantly.

Fatal abdominal injuries in a bicycle-pedestrian collision - Reconstruction using multibody simulation.

Fatal bicycle-pedestrian collisions do not occur frequently and thus are rarely reported in literature. Pedestrians in bicycle-pedestrian accidents often sustain severe craniocerebral injuries caused by a collision induced fall with head impact on the road surface. We describe a case where a pedestrian crossing a road was hit by a bicycle. Hematomas of the left lower leg and of the left flank/abdomen were found to be caused by the primary impact. However, the fatal injuries were found to be contralateral with a rupture of the right renal pedicle, a rupture of the right lobe of the liver and a tear of the vena cava. Neither the bicycle impact nor a fall onto the road surface could cause these injuries. Multibody simulation (PC Crash 9.2) revealed entanglement between the bicyclist and the pedestrian followed by a contact interaction between the pedestrian laying on the road surface and the falling bicyclist. In forensic case work post-crash contact interactions between the bicyclist and the pedestrian should be considered as a potential source of severe injuries.

Influence of posterior cruciate ligament tension on tibiofemoral and patellofemoral joint contact mechanics in cruciate-retaining total knee replacement: a combined musculoskeletal multibody and finite-element simulation.

The influence of posterior cruciate ligament (PCL) tension on the clinical outcome of cruciate-retaining total knee replacement (CR-TKR) remains controversial. Various numerical approaches have been used to study this influence systematically, but the models used are limited by certain assumptions and simplifications. Therefore, the objective of this computational study was to develop a combined musculoskeletal multibody and finite-element simulation during a squat motion to 90° knee flexion with a CR-TKR design to overcome previous limitations regarding model inputs. In addition, different PCL tensions (tight, lax, resected) were modeled and the influence on tibiofemoral and resurfaced patellofemoral joint dynamics and contact stresses was evaluated. The effect of the PCL on knee joint dynamics and contact stresses was more pronounced at higher flexion angles. Tibiofemoral joint dynamics were influenced and a tight PCL induced increased posterior femoral translation during flexion. The maximum contact stress in the tibial insert increased from 20.6 MPa to 22.5 MPa for the resected and tightest PCL at 90° knee flexion. Patellofemoral joint dynamics were only slightly affected by PCL tension. However, the maximum contact stress in the patellar component decreased from 58.0 MPa to 53.7 MPa for the resected and tightest PCL at 90° knee flexion. The combination of musculoskeletal multibody and finite-element simulation is a sufficient method to comprehensively investigate knee joint dynamics and contact stresses in CR-TKR. The PCL tension after CR-TKR affects joint dynamics and contact stresses at the articulating implant surfaces.

Head impact kinematics and injury risks during E-scooter collisions against a curb.

E-scooters as a mode of transportation is rapidly growing in popularity. This study evaluates head impact conditions and injury risk associated with E-scooter crashes. A multibody model of E-scooter falls induced by wheel-curb collision was built and compared with an experimental E-scooter crash test. A total of 162 crash scenarios were simulated to assess the effect of fall conditions (E-scooter initial speed and inclination, obstacle orientation, and user size) on the head impact kinematics. The forehead hit the ground first in 44% of simulations. The average tangential and normal impact speeds were 3.5 m/s and 4.8 m/s respectively. Nearly 100% of simulations identified a risk of concussion (linear acceleration peak >82 g and rotational acceleration peak >6383 rad/s2) and 90% of simulations suggested a risk of severe head injuries (HIC>700). This work provides preliminary data useful for the assessment and design of protective gears.

Patella height influences patellofemoral contact and kinematics following cruciate-retaining total knee replacement.

The role of patella height is discussed controversially in total knee arthroplasty (TKA). Therefore, this computational study aims to systematically analyze the biomechanical effect of different patella heights on patellofemoral (PF) forces and kinematics after cruciate-retaining (CR) TKA. We implemented a CR bicondylar TKA with a dome patellar button in a validated dynamic musculoskeletal multibody model of a male human knee joint. Retropatellar dynamics (contact force [N], shear force [N], patellar shift [mm], tilt [°], and rotation [°]) were evaluated during dual-limb squat motion (flexion from 0° to 90°) with simulated active muscle forces and the effects of different patella heights (Blackburne-Peel [BP] ratio of 0.39, 0.49, 0.65, 0.85, 1.01, and 1.1 were systematically examined). As active knee flexion increased, PF contact force also increased. Patella alta (BP = 1.1) resulted in higher PF contact forces compared to normal patella height (BP = 0.65) by up to 16%. Contrarily, patella baja was associated with decreased PF forces by 7%. Compared to patella baja (BP = 0.39), patella alta (BP = 1.1) considerably increased the contact force by up to 25%. Different patellar heights mainly affected PF shear forces during early knee flexion. Concerning PF kinematics, patella alta (BP = 1.1) yielded a greater lateral tilt of more than 4° and higher patellar rotation by up to 3° during deep knee flexion, compared to normal patella height (BP = 0.65). Our computational study indicates that patella alta is associated with the highest PF contact and shear force after the implantation of a CR bicondylar TKA. This should be considered in PF disorders following TKA.

Computer-based analysis of different component positions and insert thicknesses on tibio-femoral and patello-femoral joint dynamics after cruciate-retaining total knee replacement.

BACKGROUND: Positioning of the implant components and tibial insert thickness constitute critical aspects of total knee replacement (TKR) that influence the postoperative knee joint dynamics. This study aimed to investigate the impact of implant component positioning (anterior-posterior and medio-lateral shift) and varying tibial insert thickness on the tibio-femoral (TF) and patello-femoral (PF) joint kinematics and contact forces after cruciate-retaining (CR)-TKR. METHOD: A validated musculoskeletal multibody simulation (MMBS) model with a fixed-bearing CR-TKR during a squat motion up to 90° knee flexion was deployed to calculate PF and TF joint dynamics for varied implant component positions and tibial insert thicknesses. Evaluation was performed consecutively by comparing the respective knee joint parameters (e.g. contact force, quadriceps muscle force, joint kinematics) to a reference implant position. RESULTS: The PF contact forces were mostly affected by the anterior-posterior as well as medio-lateral positioning of the femoral component (by 3 mm anterior up to 31 % and by 6 mm lateral up to 14 %). TF contact forces were considerably altered by tibial insert thickness (24 % in case of + 4 mm increase) and by the anterior-posterior position of the femoral component (by 3 mm posterior up to 16 %). Concerning PF kinematics, a medialised femoral component by 6 mm increased the lateral patellar tilt by more than 5°. CONCLUSIONS: Our results indicate that regarding PF kinematics and contact forces the positioning of the femoral component was more critical than the tibial component. The positioning of the femoral component in anterior-posterior direction on and PF contact force was evident. Orthopaedic surgeons should strictly monitor the anterior-posterior as well as the medio-lateral position of the femoral component and the insert thickness.

Recent Advances in Coupled MBS and FEM Models of the Spine-A Review.

How back pain is related to intervertebral disc degeneration, spinal loading or sports-related overuse remains an unanswered question of biomechanics. Coupled MBS and FEM simulations can provide a holistic view of the spine by considering both the overall kinematics and kinetics of the spine and the inner stress distribution of flexible components. We reviewed studies that included MBS and FEM co-simulations of the spine. Thereby, we classified the studies into unidirectional and bidirectional co-simulation, according to their data exchange methods. Several studies have demonstrated that using unidirectional co-simulation models provides useful insights into spinal biomechanics, although synchronizing the two distinct models remains a key challenge, often requiring extensive manual intervention. The use of a bidirectional co-simulation features an iterative, automated process with a constant data exchange between integrated subsystems. It reduces manual corrections of vertebra positions or reaction forces and enables detailed modeling of dynamic load cases. Bidirectional co-simulations are thus a promising new research approach for improved spine modeling, as a main challenge in spinal biomechanics is the nonlinear deformation of the intervertebral discs. Future studies will likely include the automated implementation of patient-specific bidirectional co-simulation models using hyper- or poroelastic intervertebral disc FEM models and muscle forces examined by an optimization algorithm in MBS. Applications range from clinical diagnosis to biomechanical analysis of overload situations in sports and injury prediction.

Characteristic analysis and reconstruction method of falls from windows.

Fall accidents from windows usually start indoors, so it is impossible to secure witnesses or video clips of the initial fall situation, and there are difficulties such as a complicated fall process, but related studies are rare. In this study, the types of window fall accidents are classified, and behavior characteristics are analyzed through multibody simulation analysis based on the initial fall postures and speed values from the experimental results. And, in case studies of carefully selected real events, a method for specifying the type of window fall accident is presented along with the reconstruction simulation results using a fuzzy tool for type estimation. It is believed that the results of the characteristic analysis for each type of window fall accidents and the reconstruction method proposed in this paper will be useful for related forensic investigations.

Reconstruction of a real-world car-to-pedestrian collision using geomatics techniques and numerical simulations.

The aim of this study is to provide an improved method for traffic accident reconstruction based on geomatics techniques and numerical simulations. A combination of various techniques was used. First, an unmanned aerial vehicle (UAV), laser scanner and structured-light scanner were used to obtain information on the accident scene, vehicle and victim. The collected traces provided detailed initial impact conditions for subsequent numerical simulations. Then, multi-body system (MBS) simulations were conducted to reconstruct the kinematics of the car-to-pedestrian collision. Finally, a finite element (FE) simulation using the THUMS model was performed to predict injuries. A real-life vehicle-pedestrian collision was used to verify the feasibility and effectiveness of this method. The reconstruction result revealed that the kinematic and injury predictions of the numerical simulations effectively conformed to the surveillance video and investigation of the actual accident. UAV photogrammetry was demonstrated to be more efficient in accident data collection than hand sketch and measurement, and 3D laser scanning enabled an easier and more accurate modeling process of vehicle. The present study shows the feasibility of this method for use in traffic accident reconstruction.

Multiobjective optimization algorithm for accurate MADYMO reconstruction of vehicle-pedestrian accidents.

In vehicle-pedestrian accidents, the preimpact conditions of pedestrians and vehicles are frequently uncertain. The incident data for a crash, such as vehicle deformation, injury of the victim, distance of initial position and rest position of accident participants, are useful for verification in MAthematical DYnamic MOdels (MADYMO) simulations. The purpose of this study is to explore the use of an improved optimization algorithm combined with MADYMO multibody simulations and crash data to conduct accurate reconstructions of vehicle-pedestrian accidents. The objective function of the optimization problem was defined as the Euclidean distance between the known vehicle, human and ground contact points, and multiobjective optimization algorithms were employed to obtain the local minima of the objective function. Three common multiobjective optimization algorithms-nondominated sorting genetic algorithm-II (NSGA-II), neighbourhood cultivation genetic algorithm (NCGA), and multiobjective particle swarm optimization (MOPSO)-were compared. The effect of the number of objective functions, the choice of different objective functions and the optimal number of iterations were also considered. The final reconstructed results were compared with the process of a real accident. Based on the results of the reconstruction of a real-world accident, the present study indicated that NSGA-II had better convergence and generated more noninferior solutions and better final solutions than NCGA and MOPSO. In addition, when all vehicle-pedestrian-ground contacts were considered, the results showed a better match in terms of kinematic response. NSGA-II converged within 100 generations. This study indicated that multibody simulations coupled with optimization algorithms can be used to accurately reconstruct vehicle-pedestrian collisions.

Modeling and Simulation of Robotic Grasping in Simulink Through Simscape Multibody.

Grasping and dexterous manipulation remain fundamental challenges in robotics, above all when performed with multifingered robotic hands. Having simulation tools to design and test grasp and manipulation control strategies is paramount to get functional robotic manipulation systems. In this paper, we present a framework for modeling and simulating grasps in the Simulink environment, by connecting SynGrasp, a well established MATLAB toolbox for grasp simulation and analysis, and Simscape Multibody, a Simulink Library allowing the simulation of physical systems. The proposed approach can be used to simulate the grasp dynamics in Simscape, and then analyse the obtained grasps in SynGrasp. The devised functions and blocks can be easily customized to simulate different hands and objects.

A Finite Element Model of Cerebral Vascular Injury for Predicting Microbleeds Location.

Finite Element (FE) models of brain mechanics have improved our understanding of the brain response to rapid mechanical loads that produce traumatic brain injuries. However, these models have rarely incorporated vasculature, which limits their ability to predict the response of vessels to head impacts. To address this shortcoming, here we used high-resolution MRI scans to map the venous system anatomy at a submillimetre resolution. We then used this map to develop an FE model of veins and incorporated it in an anatomically detailed FE model of the brain. The model prediction of brain displacement at different locations was compared to controlled experiments on post-mortem human subject heads, yielding over 3,100 displacement curve comparisons, which showed fair to excellent correlation between them. We then used the model to predict the distribution of axial strains and strain rates in the veins of a rugby player who had small blood deposits in his white matter, known as microbleeds, after sustaining a head collision. We hypothesised that the distribution of axial strain and strain rate in veins can predict the pattern of microbleeds. We reconstructed the head collision using video footage and multi-body dynamics modelling and used the predicted head accelerations to load the FE model of vascular injury. The model predicted large axial strains in veins where microbleeds were detected. A region of interest analysis using white matter tracts showed that the tract group with microbleeds had 95th percentile peak axial strain and strain rate of 0.197 and 64.9 s-1 respectively, which were significantly larger than those of the group of tracts without microbleeds (0.163 and 57.0 s-1). This study does not derive a threshold for the onset of microbleeds as it investigated a single case, but it provides evidence for a link between strain and strain rate applied to veins during head impacts and structural damage and allows for future work to generate threshold values. Moreover, our results suggest that the FE model has the potential to be used to predict intracranial vascular injuries after TBI, providing a more objective tool for TBI assessment and improving protection against it.

Model-Based Biomechanical Exoskeleton Concept Optimization for a Representative Lifting Task in Logistics.

Occupational exoskeletons are a promising solution to prevent work-related musculoskeletal disorders (WMSDs). However, there are no established systems that support heavy lifting to shoulder height. Thus, this work presents a model-based analysis of heavy lifting activities and subsequent exoskeleton concept optimization. Six motion sequences were captured in the laboratory for three subjects and analyzed in multibody simulations with respect to muscle activities (MAs) and joint forces (JFs). The most strenuous sequence was selected and utilized in further simulations of a human model connected to 32 exoskeleton concept variants. Six simulated concepts were compared concerning occurring JFs and MAs as well as interaction loads in the exoskeleton arm interfaces. Symmetric uplifting of a 21 kg box from hip to shoulder height was identified as the most strenuous motion sequence with highly loaded arms, shoulders, and back. Six concept variants reduced mean JFs (spine: >70%, glenohumeral joint: >69%) and MAs (back: >63%, shoulder: >59% in five concepts). Parasitic loads in the arm bracing varied strongly among variants. An exoskeleton design was identified that effectively supports heavy lifting, combining high musculoskeletal relief and low parasitic loads. The applied workflow can help developers in the optimization of exoskeletons.

Immediate Effects of Medially Posted Insoles on Lower Limb Joint Contact Forces in Adult Acquired Flatfoot: A Pilot Study.

Flatfoot is linked to secondary lower limb joint problems, such as patellofemoral pain. This study aimed to investigate the influence of medial posting insoles on the joint mechanics of the lower extremity in adults with flatfoot. Gait analysis was performed on fifteen young adults with flatfoot under two conditions: walking with shoes and foot orthoses (WSFO), and walking with shoes (WS) in random order. The data collected by a vicon system were used to drive the musculoskeletal model to estimate the hip, patellofemoral, ankle, medial and lateral tibiofemoral joint contact forces. The joint contact forces in WSFO and WS conditions were compared. Compared to the WS group, the second peak patellofemoral contact force (p < 0.05) and the peak ankle contact force (p < 0.05) were significantly lower in the WSFO group by 10.2% and 6.8%, respectively. The foot orthosis significantly reduced the peak ankle eversion angle (p < 0.05) and ankle eversion moment (p < 0.05); however, the peak knee adduction moment increased (p < 0.05). The reduction in the patellofemoral joint force and ankle contact force could potentially inhibit flatfoot-induced lower limb joint problems, despite a greater knee adduction moment.

Musculoskeletal Multibody Simulation Analysis on the Impact of Patellar Component Design and Positioning on Joint Dynamics after Unconstrained Total Knee Arthroplasty.

Patellofemoral (PF) disorders are considered a major clinical complication after total knee replacement (TKR). Malpositioning and design of the patellar component impacts knee joint dynamics, implant fixation and wear propagation. However, only a limited number of studies have addressed the biomechanical impact of the patellar component on PF dynamics and their results have been discussed controversially. To address these issues, we implemented a musculoskeletal multibody simulation (MMBS) study for the systematical analysis of the patellar component's thickness and positioning on PF contact forces and kinematics during dynamic squat motion with virtually implanted unconstrained cruciate-retaining (CR)-TKR. The patellar button thickness clearly increased the contact forces in the PF joint (up to 27%). Similarly, the PF contact forces were affected by superior-inferior positioning (up to 16%) and mediolateral positioning (up to 8%) of the patellar button. PF kinematics was mostly affected by the mediolateral positioning and the thickness of the patellar component. A medialization of 3 mm caused a lateral patellar shift by up to 2.7 mm and lateral patellar tilt by up to 1.6°. However, deviations in the rotational positioning of the patellar button had minor effects on PF dynamics. Aiming at an optimal intraoperative patellar component alignment, the orthopedic surgeon should pay close attention to the patellar component thickness in combination with its mediolateral and superior-inferior positioning on the retropatellar surface. Our generated MMBS model provides systematic and reproducible insight into the effects of patellar component positioning and design on PF dynamics and has the potential to serve as a preoperative analysis tool.

A comprehensive and volumetric musculoskeletal model for the dynamic simulation of the shoulder function.

We present a volumetric and extensive finite element model of the shoulder usable in the context of inverse control, in which the scapula is left unconstrained on the ribcage. Such a model allows for exploring various shoulder movements, which are essential for making patient-specific decisions. The proposed model consists of 23 volumetric muscles parts modelled using the finite element method. The glenohumeral, acromioclavicular and sternoclavicular joints are modelled with soft ball-socket constraints. The musculoskeletal model can be controlled by a tracking-based algorithm, finding the excitations values in the muscles needed to follow some target points. The moment arms obtained during abduction and rotation are compared with the literature, which includes results from cadaveric data and a fine FE model of the rotator cuff and the deltoid. We simulated the paralysis of serratus anterior, a main reason of scapular winging, and compared it with its physiological counterpart. A deficiency in the range of motion as well as a reduction in upward rotation were observed, which both corroborate clinical observations. This is one of the most comprehensive model of the shoulder, which can be used to study complex pathologies of the shoulder and their impact on functional outcome such as range-of-motion.

Analysis of rider and child pillion passenger kinematics along with injury mechanisms during motorcycle crash.

Objective: Traffic fatalities among motorcycle users are intolerably high in Thailand. They account for 73% of the total number of road fatalities. Children are also among these victims. To improve countermeasures and design of protection equipment, understanding the biomechanics of motorcycle users under impact conditions is necessary. The objective of this work is to analyze the overall kinematics and injuries sustained by riders and child pillion passengers in various accident configurations. Methods: Motorcycle accident data were analyzed. Common accident scenarios and impact parameters were identified. Two numerical approaches were employed. The multibody model was validated with a motorcycle crash test and used to generate possible accident cases for various impact conditions specified to cover all common accident scenarios. Specific impact conditions were selected for detailed finite element analysis. The finite element simulations of motorcycle-to-car collisions were conducted to provide insight into kinematics and injury mechanisms. Results: Global kinematics found when the motorcycle's front wheel impacts a car (config-MC) highlighted the translation motion of both the rider and passenger toward the impact position. The rider's trunk impacted the handlebar and the head either impacted the car or missed. The hood constituted the highest head impact occurrence for this configuration. The child mostly impacted the rider's back. Different kinematics were found when car impacted the lateral side of the motorcycle (config-CM). Upper bodies of both rider and child were laterally projected toward the car front. The windshield constituted the highest proportion of head impacts. The hood and A-pillar recorded a moderate proportion. The rider in finite element simulations with config-MC experienced high rib stress, lung strain, and pressure beyond the injury limit. A high head injury criterion was observed when the head hit the car. However, the simulation with config-CM exhibited high lower extremities stress and lung pressure in both occupants. Hyperextension of the rider's neck was observed. The cumulative strain damage measure of the child's brain was higher than the threshold for diffuse axonal injury (DAI). Conclusions: This study revealed 2 kinematics patterns and injury mechanisms. Simulations with config-MC manifested a high risk of head and thorax injury to the rider but a low risk of severe injury to the child. Thorax injury to the rider due to handlebar impact was only found in simulations with config-MC. However, a high risk of skull, lower extremity, brain, and neck injuries were more pronounced for cases with config-CM. A high risk of DAI was also noticed for the child. In simulations with config-CM the child exhibited a higher risk of severe injury.

Extended foot-ankle musculoskeletal models for application in movement analysis.

Multibody simulations of human motion require representative models of the anatomical structures. A model that captures the complexity of the foot is still lacking. In the present work, two detailed 3D multibody foot-ankle models generated based on CT scans using a semi-automatic tool are described. The proposed models consists of five rigid segments (talus, calcaneus, midfoot, forefoot and toes), connected by five joints (ankle, subtalar, midtarsal, tarsometatarsal and metatarsophalangeal), one with 15DOF and the other with 8DOF. The calculated kinematics of both models were evaluated using gait trials and compared against literature, both presenting realistic results. An inverse dynamic analysis was performed for the 8DOF model, again presenting feasible dynamic results.

A virtual test system representing the distribution of pedestrian impact configurations for future vehicle front-end optimization.

OBJECTIVES: The purpose of this study is to define a computationally efficient virtual test system (VTS) to assess the aggressivity of vehicle front-end designs to pedestrians considering the distribution of pedestrian impact configurations for future vehicle front-end optimization. The VTS should represent real-world impact configurations in terms of the distribution of vehicle impact speeds, pedestrian walking speeds, pedestrian gait, and pedestrian height. The distribution of injuries as a function of body region, vehicle impact speed, and pedestrian size produced using this VTS should match the distribution of injuries observed in the accident data. The VTS should have the predictive ability to distinguish the aggressivity of different vehicle front-end designs to pedestrians. METHODS: The proposed VTS includes 2 parts: a simulation test sample (STS) and an injury weighting system (IWS). The STS was defined based on MADYMO multibody vehicle to pedestrian impact simulations accounting for the range of vehicle impact speeds, pedestrian heights, pedestrian gait, and walking speed to represent real world impact configurations using the Pedestrian Crash Data Study (PCDS) and anthropometric data. In total 1,300 impact configurations were accounted for in the STS. Three vehicle shapes were then tested using the STS. The IWS was developed to weight the predicted injuries in the STS using the estimated proportion of each impact configuration in the PCDS accident data. A weighted injury number (WIN) was defined as the resulting output of the VTS. The WIN is the weighted number of average Abbreviated Injury Scale (AIS) 2+ injuries recorded per impact simulation in the STS. Then the predictive capability of the VTS was evaluated by comparing the distributions of AIS 2+ injuries to different pedestrian body regions and heights, as well as vehicle types and impact speeds, with that from the PCDS database. Further, a parametric analysis was performed with the VTS to assess the sensitivity of the injury predictions to changes in vehicle shape (type) and stiffness to establish the potential for using the VTS for future vehicle front-end optimization. RESULTS: An STS of 1,300 multibody simulations and an IWS based on the distribution of impact speed, pedestrian height, gait stance, and walking speed is broadly capable of predicting the distribution of pedestrian injuries observed in the PCDS database when the same vehicle type distribution as the accident data is employed. The sensitivity study shows significant variations in the WIN when either vehicle type or stiffness is altered. CONCLUSIONS: Injury predictions derived from the VTS give a good representation of the distribution of injuries observed in the PCDS and distinguishing ability on the aggressivity of vehicle front-end designs to pedestrians. The VTS can be considered as an effective approach for assessing pedestrian safety performance of vehicle front-end designs at the generalized level. However, the absolute injury number is substantially underpredicted by the VTS, and this needs further development.