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Technical Note
Abstract
An analytical model of the knee joint was developed to estimate the forces at the knee during exercise. Muscle forces were estimated
based upon electromyographic activities during exercise and during maximum voluntary isometric contraction (MVIC), physiological
cross-sectional area (PCSA), muscle fiber length at contraction and the maximum force produced by an unit PCSA under MVIC.
Tibiofemoral compressive force and cruciate ligaments tension were determined by using resultant force and torque at the knee,
muscle forces, and orientations and moment arms of the muscles and ligaments. An optimization program was used to minimize the
errors caused by the estimation of the muscle forces. The model was used in a ten-subject study of open kinetic chain exercise (seated
knee extension) and closed kinetic chain exercises (leg press and squat). Results calculated with this model were compared to those
from a previous study which did not consider muscle length and optimization. Peak tibiofemoral compressive forces were
3134$1040 N during squat, 3155$755 N during leg press and 3285$1927 N during knee extension. Peak posterior cruciate
ligament tensions were 1868$878 N during squat, 1866$383 N during leg press and 959$300 N for seated knee extension. No
significant anterior cruciate ligament (ACL) tension was found during leg press and squat. Peak ACL tension was 142$257 N during
seated knee extension. It is demonstrated that the current model provided better estimation of knee forces during exercises, by
preventing significant overestimates of tibiofemoral compressive forces and cruciate ligament tensions. ( 1998 Elsevier Science Ltd.
All rights reserved.
Keywords: Knee model; Muscle force; Cruciate ligament; Knee exercise
1. Introduction
Understanding the biomechanics of the knee during
exercises, such as knee extension, leg press and squat, is
very important for therapists to design rehabilitation
programs and for trainers to strengthen and condition
athletes. Muscle force, ligament tension and joint contact
forces between the femur and tibia during exercise are the
main issues to evaluate exercises. For example, therapists
try not to overload the anterior cruciate ligament (ACL)
for ACL injured and reconstructed patients during their
rehabilitation programs. It has been controversial which
exercise should be utilized for a patient since the ACL
tension during different exercises are not fully understood (Wilk et al., 1997).
* Corresponding author. Tel.: 001 205 918-2138; fax: 001 205 9180800; e-mail: glennf@asmi.org
0021-9290/98/$19.00 ( 1998 Elsevier Science Ltd. All rights reserved.
PII: S 0 0 2 1 - 9 2 9 0 ( 9 8 ) 0 0 0 5 6 - 6
Recently, resultant forces of the knee during different exercises have been studied (Lutz et al., 1993; Stuart
et al., 1996; Wilk et al., 1996). Some efforts were made
in these studies to estimate muscle forces and to compare muscle activity; however, further study of tensions
of cruciate ligaments and the bone-to-bone contact
force of the tibiofemoral joint was prevented by limits
of the biomechanical models utilized. Muscle forces
were estimated based only on the physiological crosssectional area and electromyographic activities, not
muscle fiber length at contraction. Thus, muscle forces
were overestimated at full extension for the knee extensors without taking into account the shorter muscle fiber
length.
The purpose of this study was to develop an analytical
model of the knee in the sagittal plane during quasistatic
(i.e. isometric or low speed) exercise. The tibiofemoral
compressive force and tensions of the anterior and posterior cruciate ligament were presented during the knee
extension, leg press and squat.
964
(1)
(2)
(3)
(4)
965
Table 1
Muscle moment arm lengths (, m) as a polynomial function of knee angle (h, degree) based on Herzog and Read (1993)
Function
Coefficient
Patellar tendon
Biceps femoris
Semimembranosus
Semitendinosus
Gastrocnenius
B
0
4.71E-02
1.46E-02
2.84E-02
!4.11E-03
1.99E-02
B
1
4.20E-04
!9.26E-05
!1.61E-04
5.86E-04
!3.50E-04
B
2
!8.96E-06
8.55E-06
6.81E-06
6.90E-06
9.20E-06
B
3
4.47E-08
!8.78E-08
!8.80E-08
!5.31E-8
!1.03E-07
B
4
0.00
2.38E-10
2.77E-10
0.00
4.07E-10
Table 2
Lines of action for muscles and ligaments (/, degree, 0 to the anterior, 90 to the inferior) as a polynomial function of knee angle (h, degree, 0 for full
extension) based on Herzog and Read (1993)
Function
Coefficient
Patellar tendon
Biceps femoris
Semimembranosus
Semitendinosus
Gastrocnenius
Anterior cruciate ligament
Posterior cruciate ligament
B
0
!74.40
275.00
260.00
255.00
!90.00
227.00
!66.00
B
1
!5.75E-02
!0.8720
!0.8880
!0.8160
0.00
!0.4880
0.7370
2
n.
n.
f (c )" + (1!c )2#j M ! + M
i
3%4
.i
i
i/1
i/1
c )c )c ,
(6)
-08
i
)*')
B
2
!4.75E-03
!7.12E-04
!8.52E-04
2.63E-04
0.00
0.00
!4.96E-03
B
3
3.09E-05
0.00
0.00
!6.19E-6
0.00
0.00
where c and c
were the lower and upper limit for
-08
)*')
c and j was a constant. The coefficient c was set at one at
i
i
beginning and adjusted by using the DavidonFletcher
Powell algorithm (Dennis and Schnabel, 1983).
To test the model, previously collected data were used
(Wilk et al., 1996). A three-dimensional motion analysis
system (Motion Analysis Corporation, Santa Rosa, CA,
U.S.A.) and force platform (Advanced Mechanical Technology, Inc., Newton, MA, U.S.A.) were used to collect
kinematic data, external loads and ground reaction forces for ten subjects performing three exercises: seated
knee extension, leg press and squat. The knee flexion or
extension angular velocities were found to be approximately 90 s~1 for peak value and approximately 60 s~1
for average, making data acceptable for the quasistatic
assumption in the model. The resultant force and moment at the knee were determined by using threedimensional rigid link models and principles of inverse
dynamics (Feltner and Dapena, 1989; Wilk et al., 1996).
Surface EMG data were collected from rectus femoris,
vastus lateralis, vastus medialis, biceps femoris, medial
hamstrings and gastrocnemius muscles with a Noraxon
system (Noraxon, Pheonix, AZ, U.S.A.). The average of
the rectus femoris, vastus lateralis and vastus medialis
EMG data was used to represent the EMG data of the
vastus intermedius. EMG data of the medial hamstrings
were used for both the semitendinosus and semimembranosus. The window average of EMG during exercises
was expressed as a percentage of the window average of
EMG during the maximum voluntary isometric contraction, which was recorded when the muscle forcelength
966
factor was one, and then the average for three repetitions
of each exercise was taken based on the knee angle. In
order to consider the electromechanical delay window
averages were calculated only for past history with a window width of 100 ms. The c , c
and were set to 0.5,
-08 )*')
1.5 and 1.0, respectively, for optimization.
3. Results
The tibiofemoral compressive force during leg press
and squat increased with knee flexion angle, while the
tibiofemoral compressive force during knee extension
increased with decrease of knee flexion angle (Fig. 2).
Peak tibiofemoral forces were 3134$1040 N during
the squat, 3155$755 N during the leg press and
3285$1927 N during the knee extension.
There were no significant tension in the anterior cruciate ligament during the leg press and squat (Fig. 2). The
tension in the anterior cruciate ligament increased when
the knee approached full extension during the seated
knee extension with a peak value of 142$257 N. In
general, tension in the posterior cruciate ligament increased with knee flexion. Peak PCL tensions were
1868$878 N during the squat, 1866$383 N during the
leg press and 959$300 N during the seated knee extension. Optimization produced significant adjustments on
muscle forces (Fig. 3).
4. Discussion
A planar quasistatic model of the knee in the sagittal
plane was developed, which can be expanded to threedimensional when lines of action and moment arms of
ligaments and muscles are determined in three dimensions. The model was used for a study of 10 subjects
performing the knee extension, leg press and squat
(Zheng et al., 1996). The model took into account muscle
activities, especially the co-contraction of the extensors
and flexors of the knee. Although co-contraction of the
hamstrings and quadriceps may have no effect on the
extension torque of the knee joint, it has a significant
effect on tibiofemoral compressive force and anteroposterior shear force. Co-contraction of the hamstrings and
quadriceps is an important factor in determining tensions
in the cruciate ligaments. The co-contraction has more
effect on the tension in the posterior cruciate ligament
when the knee flexed 90, and has more effect on the
tension in the anterior cruciate ligament when the knee is
near full extension. This is due to varying lines of action
for the patellar tendon and hamstrings muscle. Thus, it is
important to take into account the co-contraction of the
hamstrings and quadriceps.
The model provided better estimation of internal forces of the knee during exercises than those in previous
Fig. 3. Muscle force estimation of quadriceps before and after optimization for a squat of one subject. Optimization had significant adjustments on muscle forces.
studies which did not consider muscle length and optimization. Linear muscle activityforce relationship was
assumed at a given knee flexion angle (Bean et al., 1988;
Lawrence et al., 1983). The muscle forcelength factor
k was about 0.25 for vastus lateralis, medialis and intermedius when the knee was in full extension. By ignoring
the forcelength factor the muscle forces would be estimated as high as four times. When only EMG and PCSA
were considered, the tibiofemoral compressive forces
were overestimated with peak values of 6139$1709 N
during the squat, 5762$1508 N during the leg press and
4598$2547 N during the knee extension (Wilk et al,,
1996), much higher than those calculated with this model.
By ignoring the forcelength factor of the muscles, higher
tibiofemoral compressive force (3453$1313) at 30 knee
flexion was reported than that (2198$805) at 90 during
References
Bean, J.C., Chaffin, D.B., Schultz, A.B., 1988. Biomechanical model
calculation of muscle contraction forces: a double linear programming method. Journal of Biomechanics 21, 5966.
Cholewicki, J., McGill, S.M., 1994. EMG assisted optimization: a hybrid approach for estimating muscle forces in an indeterminate
biomechanical model. Journal of Biomechanics 27, 12871289.
Cholewicki, J, McGill, S.M., Norman, R.W., 1995. Comparison of
muscle forces and joint load from an optimization and EMG assisted
lumbar spine model: towards development of a hybrid approach.
Journal of Biomechanics 28, 32131.
Crowninshield, R, Pope, M.H., Johnson, R.J., 1976. An analytical
model of the knee. Journal of Biomechanics 9, 39740.
967
Dennis, J.E., Schnabel, R.B., 1983. Numerical Methods for Unconstrained Optimization and Nonlinear Equation. Prentice-Hall, Englewod Cliff, NJ.
Feltner, M.E., Dapena, J., 1989. Three-dimensional interactions in
a two-segment kinetic chain: Part I: general model. International
Journal of Sport and Biomechanics 5, 40319.
Gordon, A.M., Huxley, A.F., Julian, F.J., 1966. The variation in isometric tension with sarcomere length in vertebrate muscle fibers. Journal
of Physiology (London) 185, 170192.
Herzog, W. Abrahams, S.K., Keurs, H., 1990. Theoretical determination of forcelength relations of intact human skeletal muscles using
the cross-bridge model. European Journal of Applied Physics 416,
113119.
Herzog, W., Read, L.J., 1993. Lines of action and moment arms of the
major force carrying structures crossing the human knee joint. Journal of Anatomy 182, 213230.
Lawrence, J.H., DeLuca, C.J., 1983. Myoelectric signal versus force
relationship in different human muscles. Journal of Applied Physiology 54, 16531659.
Lutz, G.E., Palmitier, R.A., An, K.E., Chao, E.Y.S., 1993. Comparison
of tibiofemoral joint forces during open-kinetic-chain and closedkinetic-chain exercises. Journal of Bone and Joint Surgery 75-A,
732739.
Narici, M.V., Roi, G.S., Landoni, L., 1988. Force of knee extensor and
flexor muscles and cross sectional area determined by nuclear magnetic resonance imaging. European Journal of Applied Physics 57,
3944.
Narici, M.V., Landoni, L., Minetti, A.E., 1992. Assessment of human
knee extensor muscles stress from in vivo physiological cross-sectional area and strength measurement. European Journal of Applied
Physics 65, 438444.
Pedersen, D.R., Brad, R.A., Cheng, C., Arora, J.S., 1987. Direct
comparison of muscle force predictions using linear and nonlinear programing. Journal of Biomedical Engineering 109,
192199.
Pierrynowski, M.R., 1991. Analytic representation of muscle line of
action and geometry. In: Allard, P, Stokes, I., Blanchi, J. (Eds.),
Three-dimensional Analysis of Human Movement , Human Kinetics.
pp. 215256.
Stuart, M.J., Meglan, D.A., Lutz, G.E., Growney, E.S., An, K.N., 1996.
Comparison of intersegmental tibiofemoral joint forces and muscle
activity during various closed kinetic chain exercise. American Journal of Sports Medicine 24, 792799.
Van Eijden, T.M., Kouwenhoven, E., Weijs, W.A., 1987. Mechanics of
the patellar articulation. Acta Orthopaedica Scandinavica 58,
160566.
Wickiewicz, T.L., Roy, R.R., Powell, P.L., 1983. Muscle architecture of
the human lower limb. Clinical Orthopedics and Related Research
179, 27583.
Wickiewicz, T.L., Roy, R.R., Powell, P.L., Perrin, J.J., Edgerton, V.R.,
1984. Muscle architecture and force-velocity relationships in humans.
Journal of Applied Physiology: Respiratory, Environmental and
Exercise Physiology 57, 435443.
Wilk, K.E., Escamilla, R.F., Fleisig, G.S., Barrentine, S.W., Andrews,
J.R., Boyd, M.L., 1996. A comparison of tibiofemoral joint force
and electromyographic activity during open and closed kinetic
chain exercises. American Journal of Sports Medicine 24,
518527.
Wilk, K.E., Zheng, N., Fleisig, G.S., Andrews, J.R., Clancy, W.G., 1997.
Kinetic chain exercise: implications for the anterior cruciate ligament
patient. Journal of Sports Rehabilitation 6, 125143.
Zheng, N., Fleisig, G.S., Escamilla, R.F., Barrentine, S.W., Wilk, K.E.,
Andrews, J.R., 1996. Forces at the knee during open and closed
kinetic chain exercises. Proceedings of 20th American Society of
Biomechanics Annual Meeting, Atlanta, GA, pp. 7576.