Biomechanical simulation of an amputated forearm with and without a prosthesis

In this study a computer simulation was developed for analysing the performance of a below-elbow amputated forearm, with and without a prosthesis. The upper extremity was represented in terms of two rigid bodies, the arm and the forearm. Five muscles, three elbow flexors and two elbow extensors, were included in the model. The muscle model used was the five-component model, including the contractile, parallel, series and viscous elements and the muscle mass. Dynamic and static simulations were conducted, with and without prosthesis, to study parametrically the effects of stump length, tendon distal transfer, tendon or muscle shortening and muscle physiological cross-sectional area. The performance measures which were the most affected included flexion moment of the forearm about the elbow, muscle moment, force in the joint, flexion rate and mechanical energy. The simulation presented an interesting case when the amputation site is more proximal than the anatomical insertion point of a muscle, necessitating shortening of the muscle to avoid the situation where it exerts no force. It was also found that, of the changeable parameters, the most beneficial changes in the forearm parameters for improved dynamic performance were: (a) tendon distal transfer and (b) increase of the muscle cross-sectional area, the latter achievable by means of physical training.