Review of musculoskeletal modelling in a clinical setting: Current use in rehabilitation design, surgical decision making and healthcare interventions

• Published in: Clinical biomechanics (Bristol) Vol. 83; p. 105292
• Main Authors: Smith, Samuel H.L., Coppack, Russell J., van den Bogert, Antonie J., Bennett, Alexander N., Bull, Anthony M.J.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2021
• Subjects: Biomechanics; Clinical movement analysis; Injury prevention; Joint contact forces; Muscle forces; Rehabilitation; Biomechanics; Joint contact forces; Injury prevention; Rehabilitation; Clinical movement analysis; Muscle forces
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2021.105292

Musculoskeletal modelling is a common means by which to non-invasively analyse movement. Such models have largely been used to observe function in both healthy and patient populations. However, utility in a clinical environment is largely unknown. The aim of this review was to explore existing uses of musculoskeletal models as a clinical intervention, or decision-making, tool. A literature search was performed using PubMed and Scopus to find articles published since 2010 and relating to musculoskeletal modelling and joint and muscle forces. 4662 abstracts were found, of which 39 relevant articles were reviewed. Journal articles were categorised into 5 distinct groups: non-surgical treatment, orthoses assessment, surgical decision making, surgical intervention assessment and rehabilitation regime assessment. All reviewed articles were authored by collaborations between clinicians and engineers/modellers. Current uses included insight into the development of osteoarthritis, identifying candidates for hamstring lengthening surgery, and the assessment of exercise programmes to reduce joint damage. There is little evidence showing the use of musculoskeletal modelling as a tool for patient care, despite the ability to assess long-term joint loading and muscle overuse during functional activities, as well as clinical decision making to avoid unfavourable treatment outcomes. Continued collaboration between model developers should aim to create clinically-friendly models which can be used with minimal input and experience by healthcare professionals to determine surgical necessity and suitability for rehabilitation regimes, and in the assessment of orthotic devices. •Little evidence of musculoskeletal models being used in clinical practice;•Only used in assessment, rarely used directly in treatment;•Papers only authored by collaboration between clinicians and modellers;•Bespoke models should be developed for patient-specific treatment;•Biomechanists should work with clinicians to develop user-friendly tools.