Mathematical modeling of human walking under combined hip joint contracture

V.A. Fishchenko, A.Yu. Branitsky, A.V. Gotsul, E.D. Karpinskaya


Background. Different variants of osteoarthritis of the hip joint (coxarthrosis) play a key role in reducing motor activity. The main complaint with coxarthrosis is pain; its nature, intensity, duration and localization depend on the stage of the dystrophic process. The purpose was to perform mathematical modeling for assessing the strength of the lower limb muscles, necessary to take a normal step, with contracture of the hip joint, which develops in stage III coxarthrosis. Materials and methods. Walk simulation was performed using the OpenSim software system. The gait2394 model was taken as the basic one. In the basic model, a combined contracture of the hip joint was modeled by limiting movements in different planes: flexion — 0/20/70°, rotation — 1/0/1°, abduction — 5/0/15°. The strength of the lower extremity muscles is compared when a normal model is walking, as well as a model with contracture. Results. When walking, the muscles perform predominantly flexion and extension movements, the amplitude of which does not exceed 50–60° with minimal adduction/abduction. In advanced contractures of the hip joint, walking should be mostly affected by insufficiency of the muscles responsible for flexion and extension of the lower limb. The work of the muscles has been analyzed depending on the areas of their location — posterior and anterior surface of the thigh, medial and gluteal muscles of the thigh. To take a normal step, posterior muscles of the thigh should develop strength 30 % higher than that with normal functioning of the joint, anterior muscles of the thigh work exceeding the strength by 30 %. The minimum effort of the muscles increases from 10 to 15 %, that is, there is no complete relaxation of the muscles and they are in a constant stress state. More tight muscles are: in the posterior thigh — short head of biceps femoris (by 53 %) and m.semitendinosus (by 100 %) when lifting the heel, and in the anterior surface of the thigh — rectus femoris (83.16 %) when moving the foot. M.semitendinosus does not have a period of relaxation, that is, the minimum effort exceeds the norm by 70 %. Conclusions. Contracture of the hip joint leads to a change in the anatomical relationships of the joint causing a significant disruption of the muscles. According to the data obtained by modeling the combined contracture of the hip joint, it was proved that not only hip muscles, but also the muscles of the entire lower limb are affected. The muscles responsible for hip flexion when moving the foot are the most affected ones — these are the muscles of the anterior and posterior surfaces of the thigh, and disturbances in their work lead to a change in the functioning of the muscles around the knee joint and below — around the ankle joint and the foot. Shortening the limb due to flexion contracture leads to a significant overtension of gluteal muscles, which are responsible for maintaining balance. The contracture of the hip joint affects the work of the muscles of the entire lower limb.


contracture of the hip joint; walking; coxarthrosis


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