Calculated moment-arm and muscle-tendon lengths during gait differ substantially using MR based versus rescaled generic lower-limb musculoskeletal models

Biomechanical analysis of gait relies on the use of lower-limb musculoskeletal models. Most models are based on a generic model which takes into account the subject's skeletal dimensions by isotropic or anisotropic rescaling. Alternatively, personalized models can be built based on information from magnetic resonance (MR) images. We have studied the effect of these approaches on muscle-tendon lengths (MTLs) and moment-arm lengths (MALs) for 16 major muscles of the lower limb of a normal adult during both normal and pathologic gait. For most muscles, the MTL and MAL calculated using the rescaled generic models showed high correlation values, but large offsets when compared to values calculated using personalized models. MTL and MAL differences with the personalized model are only slightly smaller for an anisotropic than for an isotropic rescaled model. Gait kinematics influenced the observed inter-model differences and correlations due to an altered range of joint angles in both gait patterns. In conclusion, both generic rescaling methods failed to accurately estimate absolute values for MTL and MAL calculated using the personalized model. However, the magnitude of MTL and MAL changes during normal and pathologic gait corresponded between all three models for most muscles. Since rescaling depends strongly on modelling assumptions and cannot fully take into account subject-specific musculoskeletal geometry, interpretation of MTL and MAL even in normal adult subjects requires extreme caution.