Host Mesh Fitting of a Generic Musculoskeletal Model of the Lower Limbs to Subject-Specific Body Surface Data: A Validation Study.

Challenges remain in accurately capturing the musculoskeletal geometry of individual subjects for clinical and biomechanical gait analysis. The aim of this study was to use and validate the Host Mesh Fitting (HMF) technique for fitting a generic anatomically based musculoskeletal model to 3D body surface data of individual subjects. The HMF technique is based on the free-form idea of deforming geometrically complex structures according to the deformation of a surrounding volumetric mesh. Using the HMF technique, an anatomically based model of the lower limbs of an adult female subject (29 years) was customized to subject-specific skin surface data of five typically developing children (mean age 10.2 years) and six children with Cerebral Palsy (CP) (mean age 9.6 years). The fitted lengths and volumes of six muscle-tendon structures were compared against measures from Magnetic Resonance (MR) images for validation purposes. The HMF technique resulted in accurate approximations of the lower limb shapes of all subjects in both study groups. The average error between the MR data and the fitted muscle-tendon lengths from HMF was 4 ± 4% in children without CP and 7 ± 5% in children with CP, respectively. The average error between the MR data and the fitted muscle volumes from HMF was 28 ± 19% in children without CP and 27 ± 28% in children with CP, respectively. This study presents a crucial step towards personalized musculoskeletal modelling for gait analysis by demonstrating the feasibility of fitting a generic anatomically based lower limb model to 3D body surface data of children with and without CP using the HMF technique. Additional improvements in the quality of fit are expected to be gained by developing age-matched generic models for different study groups, accounting for subject-specific variations in subcutaneous body fat, as well as considering supplementary data from ultrasound imaging to better capture physiological muscle tissue properties.