WO2011051891A1

WO2011051891A1 - Method for simulating a musculoskeletal system

Info

Publication number: WO2011051891A1
Application number: PCT/IB2010/054862
Authority: WO
Inventors: Arnaud Warion; Stéphanie LE ROUX; Ronan Coquin
Original assignee: Laetolis
Priority date: 2009-10-30
Filing date: 2010-10-27
Publication date: 2011-05-05
Also published as: FR2952207B1; FR2952207A1

Abstract

The present invention relates to a method implemented using a computer system (11) for simulating the musculoskeletal system of a person by means of a virtual musculoskeletal structure, the musculoskeletal structure extending from the neck to the feet and showing the feet as a deformable articulation, the input quantities applied to the musculoskeletal structure being modifiable and/or the musculoskeletal structure being modifiable by changing predefined parameters, the musculoskeletal structure taking into account: the interactions between the kinematic and dynamic behaviour of the feet and the kinematic and dynamic behaviour of at least one other articulation of the musculoskeletal system, and the movements produced in the saggital plane during the movement of the musculoskeletal system and the movements undergone by the skeleton in at least one plane other than the saggital plane. According to the invention the method includes: the movement and/or displacement of the musculoskeletal system is simulated by means of the musculoskeletal structure; and at least one of the predefined parameters of the musculoskeletal structure and/or at least one of the input quantities applied to the musculoskeletal structure are modified in order to adapt said values to the operation of the musculoskeletal system of said person.

Description

Method of simulating the musculoskeletal system

The present invention relates to a simulation method with a computer system of the musculoskeletal system of a person.

The invention relates more particularly, but not exclusively, to the determination of mechanical quantities representative of a stress exerted on the bones via the cartilages and / or muscles of the musculoskeletal system of the person in motion.

It is known to observe the movements caused by the actuation of the muscles in the sagittal plane, also called the plane of flexion / extension of the bone segments of the locomotor apparatus of a person during the movement of the latter. However, this observation does not take into account parasitic movements, also called movements of adduction / abduction and internal / external rotation undergone by the skeleton during a displacement and which can be at the origin of pathologies.

Models exist to simulate the musculoskeletal system of a person. However, these models do not consider, to the knowledge of the Applicant, the foot as a joint in interaction with the rest of the musculoskeletal system, limiting the accuracy of such models and the appropriateness of setting calibration using of these models. Such models also do not take into account, to the knowledge of the Applicant, the movements of the patella, and do not allow to manage a double condylar contact of the knee joint.

In addition, the known models do not consider the musculoskeletal system from the feet to the cervical ones.

The application US 2008/0285805 discloses a method for measuring mechanical quantities associated with movements of the human body. This request does not teach to simulate the displacement of the musculoskeletal system of a person. In addition, the model used according to this application US 2008/0285805 does not represent the foot as a knuckle, the foot being represented as a segment connected to another segment by a hinge.

There is a need to further improve the simulation techniques of the musculoskeletal system of a person, for example to determine mechanical quantities representative of a stress exerted on the muscles and / or cartilages of the bones of the musculoskeletal system. the person in motion. The object of the invention is to meet this need and it achieves this, according to one of its aspects, thanks to a method implemented with a computer system for simulating the musculoskeletal system of a person using a virtual musculoskeletal structure, the musculoskeletal structure extending from the cervical to the feet and representing the feet as a deformable joint,

input quantities applied to the musculoskeletal structure being modifiable and / or

the musculoskeletal structure being modifiable by acting on predefined parameters, the musculoskeletal structure taking into account:

the interactions between the kinematic and dynamic behavior of the feet and the kinematic and dynamic behavior of at least one other articulation of the musculoskeletal system, and

the movements caused in the sagittal plane during the displacement of the locomotor apparatus and the movements undergone by the skeleton in at least one plane other than the sagittal plane,

process in which

- the movement and / or displacement of the musculoskeletal system is simulated using the musculoskeletal structure and,

at least one of the predefined parameters of the musculoskeletal structure and / or at least one of the input quantities applied to the musculoskeletal structure is varied in order to adapt them to the functioning of the locomotor apparatus of said person.

By "adapting the musculoskeletal structure to the functioning of the musculoskeletal system of the said person", respectively "adapting the input quantity or quantities applied to the musculoskeletal structure to the functioning of the musculoskeletal system of the person", he It must be understood that data values associated with a simulation of the musculoskeletal system are associated with this muscular-skeletal structure, respectively input quantity values applied to said structure, and the values of these same data associated with this structure. the musculoskeletal system of said person, such data being for example measured or predefined.

The sagittal plane is also called the plane of flexion / extension of the bone segments of the musculoskeletal system. The adaptation of the musculoskeletal structure to the functioning of the musculoskeletal system of the person may be preceded by a step implemented using a 3D medical imaging device, such as a scanner or an MRI . During this step, the person's musculoskeletal system can be subjected to a scanner or an MRI and, in particular by a three-dimensional reconstruction, obtain a first set of values of the parameters of the musculoskeletal structure.

Thanks to the invention, it is possible to identify the specific manner of walking of each person by adapting the musculoskeletal structure and / or the input quantities applied to the structure to the functioning of the musculoskeletal system of this person.

The person whose musculoskeletal system is to be simulated can for example be a real or virtual person.

In addition, by observing the movements and forces experienced by the skeleton in at least one plane other than the sagittal plane, the invention allows to take into account movements and efforts potentially responsible for the appearance of pathologies.

The method may comprise the step of acquiring, in the static state and in movement, data relating to the musculoskeletal system of the person and / or of at least one input quantity applied to the musculoskeletal system of the person and that is varied at least one of the predefined parameters of the. musculoskeletal structure and / or at least one input quantity applied to the structure to adapt to the functioning of the musculoskeletal system of the person according to the acquired data.

As an alternative or in combination with the foregoing, the method may comprise the step of taking data relating to the musculoskeletal system of the person and / or at least one input quantity applied to the musculoskeletal system of the person. the person in the computer system and according to which at least one of the predefined parameters of the musculoskeletal structure and / or at least one input quantity applied to the structure is varied in order to adapt them to the musculoskeletal system of the person based on the data entered.

The musculoskeletal system data of the person, measured and / or entered, may correspond to predefined parameters of the musculoskeletal structure and / or to at least one input quantity applied to the structure. In a variant, said data are different from said parameters and / or input quantities.

The invention further relates, in another aspect, to a computer system for simulating the musculoskeletal system of a person using a virtual musculoskeletal structure, extending from the cervical to the feet and representing the feet as a deformable joint,

modifiable input quantities being applied to the musculoskeletal structure and / or predefined parameters of the structure being modifiable,

the musculoskeletal structure taking into account:

the movements caused in the sagittal plane during the displacement of the musculoskeletal system and the movements undergone by the skeleton in at least one plane other than the sagittal plane.

Predefined parameters of the musculoskeletal structure may be related to the shape of the bones, for example selected from bone dimensions and / or angle values between different parts of a bone or between two adjacent bones, and these parameters can be varied during the simulation by deforming the bones.

The predefined parameters of the musculoskeletal structure may be related to the shape and / or position of the muscular attachments and these parameters may be varied during the simulation by deforming and / or moving the muscle attachments.

The predefined parameters of the musculoskeletal structure can be related to the size of the cartilages, their shape and the position of the cartilages with respect to the bones.

Predefined parameters of the musculoskeletal structure can still be related to the coupling coefficients between the axes of bone segments of the musculoskeletal system.

The musculoskeletal structure can thus faithfully represent the locomotor apparatus of the person.

The foot, for example, is represented in the musculoskeletal structure as an assembly comprising between two and twenty-six articulated bones with respect to other. It can be all the actual bones of a person's foot. Such modeling of the foot can be simple enough that the movement of the foot during a simulation is done in real time while being sufficiently detailed to provide usable information.

The foot can be connected to the rest of the musculoskeletal structure by two joints:

a first articulation with respect to the Henke axis passing through a point of the upper outer portion of the astragalus head and a point of the outer lower portion of the tarsal sinus. The astragal for example performs around this axis of Henke a rotation relative to the caicanéum. This first joint can be characterized inter alia by a coefficient specific to each person and reflecting the stiffness of the joint around this axis,

a second articulation about a second axis corresponding to the axis of a cylinder passing in the middle of the contact surface between the scaphoid and the astragalus. The axis of this cylinder can define the axis of rotation of the movement between the scaphoid and the astragalus.

The input quantity can be at least one of the three rotation angles of the pelvis, the lateral offset of the pelvis, the angle of flexion of the hip, the angle of knee flexion, the width of the foot, the opening of the pitch, bending of the caicaneum with respect to the ground and the rolling direction of the caicaneum with respect to the ground.

During the process, for example, the movements experienced by the skeleton in frontal and transverse planes in which movements of the skeleton occur under the action of weight, the reaction of the soil and the holding of the passive moments exerted on the skeletons. joints corresponding to the configurable elastic stiffness of the capsules and ligaments.

When implementing the method according to embodiments of the invention, it is not necessary to measure the movements of the musculoskeletal structure in all planes, movement measurements in certain planes being able for example to be deduced from certain other measures in other plans.

The method may include the step of determining at least one mechanical quantity representative of a stress exerted on the cartilages of the bones and / or the muscles of this moving person. The mechanical quantity is for example chosen from:

the amplitude of the internal / external rotation movements of the lower limb,

the contact surfaces of the hip-femoral joints, these surfaces comprising, for example, the surface of the femoral head and / or the acetabulum.

the point of application of the efforts on the coxo-femoral joints, for example on the femoral head and / or the acetabulum, and the distribution of these,

the angle between the axis of the femoral condyles and the tibial plateau,

the rotation of the axis of the femoral condyles relative to the perpendicular to. 1 axis of the tibial plateau,

the distribution of the efforts between the two femoral condyles, the speed, the direction the orientation of! ^" Peronéo-tibio-astragalienic joint,

the contact surfaces between the tibial fibula and the astragalus dome,

the speed and direction of rolling of the calcaneus relative to the ground, the angle of rotation of the astragalus with respect to the calcaneus. the elongation of the muscles,

the interaction between the muscles and the bones,

- the pressure, on the cartilages

indicators at each pivot point and / or bearing for example the slewing rate and the turnover rate.

The invention can allow, by observing at least one of the mechanical quantities above, to detect, quantify and / or locate the causes of any existing or future pathologies.

The method may comprise the step of introducing parameters relating to at least one orthosis and / or to a prosthesis worn by the person and according to which the shape and / or the hardness of said orthosis and / or of said prosthesis are adjusted. by varying at least one of said parameters relating to said orthosis and / or to said prosthesis, so as to minimize the mechanical magnitude or quantities, which can make it possible to design an orthosis and / or a prosthesis for minimizing a pathology. Thus, after the adaptation of the musculoskeletal structure to the operation of the musculoskeletal system of said person, it may be possible to take into account during the simulation an orthosis and / or a prosthesis.

The invention can also make it possible to predict the appearance and evolution of possible pathologies in the absence of wearing orthoses or prostheses.

The method may include the step of automatically manufacturing the orthosis and / or the prosthesis according to the material, shape and / or its adjusted physical characteristics.

The orthosis is for example an orthopedic insole.

The data relating to the musculoskeletal system of the person can be acquired using sensors carried by the person and / or a force platform and / or a high-speed camera and / or a platform of capture of plantar pressure. The sensors may include at least one muscle contraction sensor, also called EMG sensors.

The computer system may include a screen and the method may include the step of displaying on the screen at least one image of the musculoskeletal structure.

The invention further relates, in another of its aspects, to a device for implementing the method above.

Another aspect of the invention is a method for determining the placement of a knee prosthesis in the musculoskeletal system of a person, the method being performed using a ^the human musculoskeletal system, especially with the musculoskeletal structure above and including the step of carrying out different simulations of the movement of the musculoskeletal system of the person using the model monitoring at least one predefined criterion.

The model, in particular the musculoskeletal structure above, for example refers to the attachment points of the lateral (and possibly crossed) ligaments of the knee and the criterion can be the evolution of the distance between said attachment points.

Alternatively the above criterion or in combination therewith, the model, including the musculoskeletal structure above, may enable to ^observe the point of application of the contact force at the interface between the condyles and shin at course of walking and position of the point of application can set a criterion for the positioning of the knee prosthesis.

The musculoskeletal structure with a prosthesis thus positioned can then be used by a surgeon before an operation. The latter can, by means of simulations with the help of this musculoskeletal structure, ensure that the prosthesis will be effective or not wear out too quickly, for example.

A positioning guide, prosthesis can be offered to the surgeon depending on the outcome of the simulation.

Following the same principle one can determine the placement of a hip prosthesis.

The invention will be better understood on reading the following description of nonlimiting examples of implementation thereof, and on examining the appended drawing, in which:

- Figure 1 schematically shows a device for implementing the method according to the invention.

FIG. 2 represents a musculoskeletal structure according to an exemplary implementation of the invention,

FIG. 3 represents an example of an acquisition system according to an example of implementation of the invention,

FIG. 4 represents a detail of FIG. 3,

FIG. 5 represents an assembly comprising a musculoskeletal structure according to claim 2 and a sole

FIG. 6 schematically represents a process for manufacturing orthopedic insoles according to an exemplary application of the invention,

FIG. 7 represents an exemplary method for identifying the dynamics of the musculoskeletal apparatus using the musculoskeletal structure and using the dynamics thus identified,

FIG. 8 schematically represents steps corresponding to the deformation of the foot during a simulation using the musculoskeletal structure,

FIG. 9 represents the portion of the knee on the femur side according to an example of a musculoskeletal structure, FIG. 10 represents the part of the knee on the side of the tibia according to an example of a musculoskeletal structure and

- Figure 1 1 is a knee prosthesis on the side of. shin embedded in an example of musculoskeletal structure.

Device

FIG. 1 shows an exemplary device 1 for implementing the method according to the invention.

The device 1 is for example designed to simulate the musculoskeletal system of a person using a virtual musculoskeletal structure 10.

This device 1 comprises a computer system 1 1 comprising a computer

2 and / or a computer 5. The computer comprises for example a screen 3 for viewing images of the musculoskeletal structure, for example when adapting the latter to the functioning of the musculoskeletal system of a person as described later. The computer 5 may or may not be integrated with the computer 2. The latter may comprise a keyboard 4 or any other user interface allowing a user to enter data.

Musculoskeletal structure

FIG. 2 shows an example of a musculoskeletal structure 10 according to the invention, representing the musculoskeletal system of the person.

This musculo-squeegetic structure 10 can extend from the feet to the cervical ones and make it possible to translate the interactions between the kinematic and dynamic behavior of the feet of the person and the kinematic and dynamic behavior of other articulations of the musculoskeletal system of the person.

The musculoskeletal structure 10 can also take into account the movements caused in the sagittal plane during the displacement of the musculoskeletal system of the person and the movements undergone by the skeleton in at least one plane other than the sagittal plane, particularly in the the frontal and transversal planes in which skeletal movements occur under the action of weight, the reaction of the soil and the holding of the passive moments exerted on the articulations.

The musculoskeletal structure allows, for example, a three-dimensional observation of the bones, an observation of the muscular attachments and points defining the cartilages. Geometric elements being for example spheres, cylinders, axes and points represent for example the various elements of the musculoskeletal structure.

This musculoskeletal structure is for example characterized by predefined parameters that can be modified by the user according to data specific to the musculoskeletal system of the person. These predefined parameters are for example related to the shape of the bones, being chosen in particular from bone dimensions and / or angles values between different parts of a bone or between two adjacent bones.

Independently or in combination with the foregoing, predefined parameters of the musculoskeletal structure may be related to the shape and / or position of the muscle attachments.

independently or in combination with the foregoing, predefined parameters of the musculoskeletal structure may be related to cartilage size, shape, and cartilage position relative to bone.

Independently or in combination with the foregoing, predefined parameters of the musculoskeletal structure may be associated with geometric rules and constraints ensuring the consistency of simulated movements at the joints. These geometric constraints relate for example:

- at the hip position; the head of the femur and the acetabulum before for example remain concentric and in the same position,

- the rotation of the hip; the center of rotation of the hip, for example, to be confused with the center of the head of the femur,

- to the. knee position,

at the rotation of the knee, the latter having for example to remain free in adduction and being imposed in flexion,

- at the position of the ankle, the center of a cylinder representing the astragal to be confused with the center of a cylinder representing the tibia,

- Rotation of the ankle, it must for example be free around the axis of the ankle and constrained according to the other two axes defining with the axis of the ankle a three-dimensional orthogonal reference.

- the rotation of the astragal with respect to the calcaneus, this rotation to be semi-free with a restoring torque having an elastic constant value configurable around the Henke axis and constrained around the other two axes defining with the Henke axis a three-dimensional orthogonal reference

- the coupling between the knee and the Henke axis, and

- movements of the foot, these movements must accompany those of the calcaneus except when the foot meets the ground.

Such predefined parameters are, for example, the coupling coefficients between the axes of bone segments of the locomotor apparatus.

The musculoskeletal structure 10 represents, for example, the foot as a deformable joint, having between two and twenty-six articulated bones, for example seventeen bones.

The musculoskeletal structure may be subject to input quantities related to movements activated by the muscles of the musculoskeletal system and on which a user can act to deman-a simulation of the movement and / or displacement of the musculoskeletal system. 'locomotor device.

The musculoskeletal structure makes it possible to observe output quantities related to movements experienced by the skeleton and which correspond, for example, to mechanical quantities representative of a stress exerted on the cartilages of the bones and / or the muscles of this person. in motion, these outputs being observable and quanti reliable at. using the device according to the invention.

At least one of the three angles of rotation of the pelvis, the lateral offset of the pelvis, the angle of flexion of the hip, the angle of flexion of the knees, the width of the step, may be chosen as input quantities. the opening of the pitch, the flexion of the calcaneus with respect to the ground and the rolling direction of the calcaneus with respect to the ground. The output quantities are for example mechanical quantities representative of a stress exerted on the cartilages of the bones and / or the muscles of the person in motion, being for example at least one of:

the amplitude of the internal / external rotation movements of the lower limb,

the contact surfaces of the coxo-femoral joints, for example the surfaces of the femoral head and / or the acetabulum.

the point of application of the efforts on the coxo-femoral joints, for example on the femoral head and / or the acetabulum and the distribution of these. the angle between the axis of the femoral condyles and the tibial plateau,

the rotation of the axis of the femoral condyles relative to the perpendicular to the axis of the tibial plateau,

the distribution of the forces between the two femoral condyles, the speed, the direction, the orientation of the peronéo-tibio-astragalic joint,

the contact surfaces between the tibial-fibula joint and the astragalus dome,

the speed and direction of calcaneal rolling relative to the ground, the angle of rotation of the astragalus with respect to the calcaneus. the elongation of the muscles,

the interaction between the muscles and the bones,

the pressure on the cartilages,

indicators at each point of pivoting and / or rolling of one surface of the joint relative to another, for example the slewing rate and the rolling rate.

Other outputs can still be considered, such as the deformation of the foot or the angles and position of the patella.

Such a choice of input quantities, when the latter are bending movements and some constants relating to the walking of the person, of output quantities, when the latter are movements in planes other than the sagittal plane, of a nature of the musculoskeletal stracture, allow the taking into account during the simulation of prosthesis (s) and / or orthotic (s).

An example of a musculoskeletal structure at the femur level will now be described in detail.

The head of the femur is represented by a sphere and the predefined parameter of the musculoskeletal stracture associated with this sphere is its radius. The radius of the femoral head can be used to define the contact surface of the cartilage.

The base of the femoral neck is represented by dots and the predefined parameter of the musculoskeletal structure associated with each point is its distance to the center of the femoral head. The two condyles are, according to this example, represented by two coaxial cylinders and the predefined parameters of the musculoskeletal structure associated therewith are the radius of the outer cylinder, the radius of the inner cylinder and the distance between the centers of the cylinders. These inner and outer radii can be used to determine the inclination of the contact surface with respect to the axis of the rolls.

Other predefined parameters associated with the femur may be the femur length, anteversion angle of the femoral neck, femoral neck opening angle and knee opening angle, the latter having influence on the length of the step and the angular velocity of the femur relative to the ground, the contact surface between the cartilage on the head of the femur and the cartilage of the acetabulum during walking, the contact force at the level of the hip and the width of the step.

Acquisition system

The device 1 may comprise an acquisition system 6, as shown in FIG. 3, which can communicate via a wired connection or not with the computer system 11.

This acquisition system 6 comprises, for example, a plurality of sensors 7 carried by the person and an example of which has been shown in FIG. 4, and / or at least one force platform 8.

In a variant, the acquisition system 6 may also comprise at least one image acquisition rate camera greater than 100 Hz and / or a platform for capturing the plantar pressure and / or one or more EMG sensors.

In the example described, the sensors 7 are mini-inertial units contained in a housing and comprising:

a three-axis accelerometer giving values of the acceleration relative to the ground of the center of the sensor housing in a reference linked to the housing, and / or

a three-axis gyrometer giving values of angular speed of the center of the housing relative to the ground in the same reference frame linked to the housing and / or,

- a three-dimensional detector of the Earth's magnetic field.

In the example of Figures 3 and 4, the sensors 7 are integrated in a combination in which the person is coated during data acquisition, such a combination is for example sold by the company Xsens ^®. In a variant not shown, the sensors 7 can be fixed on the person's clothes removably, for example by means of a bracelet or a belt.

The data acquired by each mini-inertial unit 7 may be three acceleration and angular velocity components or an orientation matrix of the housing containing the inertial mini-unit 7 with respect to a reference linked to the ground, this orientation matrix being represented by quatemions.

The data acquired by the mini-central mertielies 7 can make it possible to obtain:

- Spatial-temporal parameters such as walking speed and walking rate of the person, the length of the person's step, the width of the step, parameters such as the width of the pool, a mini-central being for example arranged on each side of the pelvis, or the length of the leg.

kinematic parameters of each bone segment of the locomotor apparatus, for example the angular velocity of said segment.

The force platform (s) 8 may be placed under a pressure pad 9 on which the person moves when acquiring the data. For example, the force platform or platforms 8 deliver in three planes the components of the contact force of the foot on the ground at a frequency, for example, greater than 200 Hz and with a spatial resolution of 0.5 cm. The force platform can also be used to determine the center of application of the contact force of the foot on the self.

By providing information on the direction of the contact force of the foot on the ground and on its application center, such force platforms can make it possible to better evaluate the kinematics of the foot, especially the heel.

The data acquired using the force platform (s) 8 and / or the pressure belt 9 can also make it possible to determine the laying phases of the foot, the width and the length of the pitch and the rolling direction of the calcaneus by ground ratio.

In a variant, the device 1 is devoid of an acquisition system 6. Deformation of the foot

The foot is preferably connected to the rest of the musculoskeletal structure by two joints: a first articulation with respect to the Henke axis passing through a point of the upper outer part of the astragalus head and a point of the outer lower part of the tarsal sinus. The astragalus performs around this Henke axis a rotation with respect to the caicaneum. This first articulation is characterized inter alia by a coefficient specific to each person and reflecting the stiffness of the joint around this axis,

a second articulation about a second axis corresponding to the axis of a cylinder passing in the middle of the contact surface between the scaphoid and the astragalus. The axis of this cylinder defines the axis of rotation of the movement between the scaphoid and the astragalus.

An example of deformation of the foot during a simulation of the displacement of the locomotor apparatus using the musculoskeletal structure 10 will now be described with reference to FIG.

During a step 50, the caicaneum rolls along a rolling curve projected on the ground, causing all the bones of the foot. The rotation around the Henke axis of the astragalus with respect to the caicaneum allows the scaphoid, astragalus and the first, second and third cuneiform to be trained as well.

The scaphoid is also displaced in rotation with respect to the astragalus along the axis of the second articulation of a sign angle opposite to that corresponding to the rotation of the astragal with respect to the caicaneum, resulting in the first, second and second third cuneiform, followed by the first, second and third metatarsals that rotate around their head in the direction of their respective cuneiform.

At the end of this step 50, the fifth metatarsal head touches the ground.

During a step 51, the caicaneum rolls around the contact axis of the heel relative to the ground, causing all the bones of the foot.

The rotation around the Henke axis of the astragalus with respect to the caicaneum allows the scaphoid, astragalus and the first, second and third cuneiform to be trained as well. The scaphoid is also displaced in rotation relative to the astragalus along the axis of the second articulation of a sign angle opposite to that corresponding to the rotation of the astragal with respect to the caicaneum, resulting in the first, second and third cuneiform, followed by the first, second and third metatarsals that rotate around their head in the direction of their respective cuneiform.

At the end of this step 51, the head of the first metatarsal touches the ground.

Step 52 corresponds to the load of the arch. During this step 52, the rotation around the axis of Henke under the load exerted by the locomotor apparatus determines the deformation of the foot.

Rotation of the astragalus around the calcaneum around Henke's Tax leads to the scaphoid, astragalus, and the first, second, and third cuneiform. The rotation of the scaphoid with respect to the astragalus around the axis of the second articulation of an angle of sign opposite to that of the angle corresponding to the rotation of the astragalus with respect to the calcaneus results in the first, second and third cuneiform .

The first metatarsal and the entire first toe are displaced by translation parallel to the ground and the axis of the foot and the axis of this first metatarsal around its point of contact with the ground is changed to a point common contact with the first cuneiform.

The second and third cuneiforms can be moved so as to obtain a uniform distribution of their center of inertia between the cuboid and the first cuneiform.

The second and third metatarsals are then rotated around their head in the direction of their respective cuneiform. The cuboid is then rotated about the axis passing through its center and the center of the heel by an angle equal to that of the angle between the center of the cuboid and the center of the first wedge-shaped.

At a step 53, the heel is detached from the ground by rotation of Lavant-foot, that is to say the part of the foot behind the toes, around the axis formed by the head of the first, second and third metatarsals . The inverse complex deformation around the Henke axis causes a reverse deformation to that of step 52 until an undeformed foot is obtained at the end of step 53 at the end of which the heel of the other foot is placed on the floor.

Improved measurement accuracy

The acquisition of data by the acquisition system 6 can involve several reference marks, namely

a reference linked to the sensor housing containing a mini-inertial unit 7, and in which the measurements are made by the mini-inertial unit 7, a magnetic marker whose axis X is directed towards the terrestrial magnetic North, and whose axes Y and Z form a horizontal plane,

a walking marker whose axis X is oriented in the direction of travel when moving a musculoskeletal apparatus in a straight line, the X, Y axes of this marker defining the sagittal plane and the Y, Z axes of this marker defining the frontal plane and,

an anatomical landmark defined for each bone segment of the locomotor apparatus with respect to functional points of these segments.

Each mini-central unit 7 is for example arranged to provide a matrix of passage of the marker linked to the housing to the magnetic mark. The march mark is deduced for example from the magnetic mark by a simple rotation of an angle around a vertical axis.

In order to obtain the angular position of the anatomical landmark of each bone segment of the musculoskeletal apparatus with respect to the walking mark, the angular position of the anatomical landmark relative to the landmarks connected to each housing of a sensor is determined for example by application of a specific protocol, this angular position being fixed during walking.

We can then determine the angular position of the reference linked to the housing of each sensor with respect to the magnetic mark which, as described above, is directly given by each mini-central inertia 7 with a precision of the order of 4 to 5 ° in motion and 1 to 2 ° in static mode, and it is possible to determine the position of the march mark relative to the magnetic mark, the running mark being fixed during walking in a straight line with respect to the magnetic mark.

It may be desirable to improve the accuracy of the measurements delivered by the mini-inertial units 7 concerning the angular position of the reference mark connected to the housing of each sensor with respect to the magnetic mark, both in static mode and in motion, the measurement errors made by these mini-inertial units 7 being for example due to the movement of the skin, the vibrations resulting from the laying of the foot on the ground, the positioning of the inertial mini-centers with respect to the magnetic mark, the positioning of the mini - inertial centers compared to the anatomical landmark and the intrinsic drift of the sensors.

To do this, we can perform measurements according to a specific protocol. During measurements, the sensors 7 of the acquisition system are fixed on the person so that it can be considered later that these sensors 7 no longer move relative to the person.

The movement of the musculoskeletal system of the person is cut off during the acquisition of measurements in five distinct phases: an initial immobile phase, a start-up phase, a cyclic phase, an end-of-step phase and an immobile final phase.

The person remains for example feet together, motionless, the soles of the feet stuck to the ground for a few seconds and the ends of both feet in front of a line marked on the ground, for example. The device 1 may include an electronic podoscope that can make it possible to verify that the feet of the person are flattened on the ground, allowing for example to estimate in part the position of the anatomical landmarks relative to the mark bound to the housing of each sensor.

The device may also comprise means for creating a constant artificial magnetic field, for example a coil, so that the external field is constant and in the same direction in the ambient environment during the initial immobile phase.

For example, the average of the accelerometer values and the outputs of a magnetometer during this initial phase is carried out and, after calculation, the initial matrix of the reference mark bound to the sensor of each box is deduced from the magnetic mark, for example, that quaternions translating the initial relationship between the reference linked to the sensor of each housing and the magnetic reference.

The slope due to the drift of the accelerometers of each inertial minicentral 7 is then measured, and the assembly is corrected so as to have a constant value on the three axes of the mark bound to the sensor housing 7.

It is possible to place a free sensor on the ground perpendicular to the line in front of the user's feet, so as to measure the angle between the magnetic mark and the mark.

We can then deduce the matrix of initial passage of the marker linked to the housing of each sensor at the march mark. All operations can be made independent of the ambient magnetic field, which allows for example to overcome the subsequent evolution of it. Still during this initial phase, it is possible to define in whole or in part the position of the anatomical landmark linked to each bone segment of the musculoskeletal system.

This initial phase can make it possible to constitute a reference position specific to each patient, to consider that the average angular velocity is zero, that the acceleration is equal to the acceleration of the gravity, and that the orientation relative to the magnetic North is fixed.

The initial phase can, for example in applications for radiology, correspond to the acquisition of a radio image in still position feet attached to the floor.

The person can then move in a straight line from a position where it is feet together to a mark on the ground away from a predefined distance, for example 6.20 meters, from the line in front of which the person was initially , so as to place the end of his feet in front of this mark. The person can then stand still feet attached to the ground for a predetermined time, for example 5 seconds.

During the cyclic phase, for example, a median filter is applied over the length of a period, this period being identifiable in two ways:

between two instants corresponding to the detachment of the foot from the ground or

- between two instants corresponding to the installation of the heel on the floor.

The use of such a median filter improves the periodicity of quatemions reflecting the relationship between the benchmark connected to the sensor of each housing and the magnetic mark during this phase of cyclic operation.

During the end-of-march phase, the representative curve of said quatemions is deformed by line or parabola so that the final value of a quaternion is close, notably equal to the initial value of a quaternion.

Finally, during the final phase it is verified that each of said quatemions is constant and equal to the initial value.

It is thus possible to take advantage of the periodicity of the values delivered by the accelerometer and the gyrometer of each sensor 7.

The device can implement a Kalman filter merging the measurements made by the sensors of each mini-inertial unit and allowing to limit the drifts of these. Such a Kalman filter can make it possible to perform a first correction on the quaternions representing the relationship between the reference linked to each sensor and the magnetic marker.

A second, finer correction can be made taking into account, as already mentioned above:

the fact that the starting and finishing positions being substantially the same, the quaternions must have values that are close, and in particular identical, for the departure and arrival phases,

- the fact that during the initial and final phases, the quaternions are constant and

the fact that during the cyclic phase, the same quantities are periodic.

One can thus improve by a few degrees the precision in motion and in static regime, which. improves the consistency of measurements.

It is also possible to make a calibration correction in the three planes of the march mark. For example, predefined parameters of the structure are used, such that they are split into three musculoskeletal structures in two dimensions. These parameters can be varied until constraints on the walking height, the total length of walking and the times of double ground contact are respected.

This correction can be used to deduce the length of bone segments of the musculoskeletal system, the length and width of the steps and some initial angles. This correction can also make it possible to fix some angles over time.

Adaptation of the musculoskeletal structure to the person

A user can adapt the musculoskeletal structure that has just been described to the functioning of the musculoskeletal system of a given person.

The same input values can be applied to the musculoskeletal structure 10 and the musculoskeletal system of the person and the outputs obtained for the person can be determined using the acquisition system 6 and then transmitted to the system. computer 1 1.

A difference between outputs from a simulation using the musculo-skeletal structure 10 and those from ^the locomotor apparatus of the The person can then be determined by the calculator 5 and then the latter can determine a new value to be applied to at least one of the predefined parameters of the musculoskeletal structure 10 or to an input quantity applied to the latter for better understanding. adapt to the functioning of the musculoskeletal system of the person.

Alternatively, the device 1 has no acquisition system and the outputs obtained using the musculoskeletal stripping are compared to values entered on the user interface 4 of the computer 2 by the user. These values are for example derived from the experience of the user who can be a doctor or any other member of the medical staff.

The adaptation can be carried out iteratively, only some, in particular only one, predefined parameters and / or input quantities being for example processed during an iteration. Alternatively, each predefined parameter and / or input variable applied to the musculoskeletal structure is treated at each iteration.

During this adaptation, the values of one or more predefined parameters can be modified by the user or automatically to:

- deform, lengthen and / or move in rotation one or more bones of the straciure,

- move one or more muscular fasteners and / or deform the same, and / or

- Change the shape of one or more cartilages and / or move this or these.

Predefined parameters relating to the bones can be modified by cutting the bones in the musculoskeletal structure into several zones of points and by applying to these points translations, rotations and / or homofneasts.

Example of knee

An example of an adaptation of the knee of the musculoskeletal structure to the locomotor apparatus of the person will now be described with reference to FIGS. 9 and 10.

Figure 9 shows an example of a knee portion of the femur side of the musculoskeletal structure. With regard to the part of the knee on the side of the femur, the radii R1 and R2 of two coaxial cylinders are determined so that these cylinders are respectively tangent to the internal and external condyle for a bending between femur and tibia between 0 and 60 °, such an angular range to adequately represent the walk of the person. The intersection of the cylinder of radius R1, respectively R2, with the plane perpendicular to the plane of tangency of this cylinder and of the inner or outer condyle respectively defines a circle of radius R1 and center (1, respectively of radius R2 and center 02.

With regard to the part of the knee lying on the side of the tibia, one looks for the plane of the tibial plateau, this plane being defined, as represented in FIG. 10 by the point Ci of the internal tibial cavity, the point C2 situated at the center of the outer tibial plate and the direction of the tibial crest Uc, this direction being such that successive traces (also called contours) of a section of the tibial plateau perpendicular to this direction leaves a trace of invariant crest. The center of the plateau Op is then determined, this center being the vertex point of the tibial crest.

A knee prosthesis can also be integrated into the musculoskeletal structure. For example, a fixed-plateau sliding prosthesis with a constant radius of curvature will be considered, but any other example of a prosthesis may be integrated into the structure. For the part of the knee on the side of the femur, the radius RI of a cylinder is determined so that the cylinder is tangential to the inner and outer condyle of the prosthesis for flexion between femur and tibia, between 0 and 60 °. The intersection of this cylinder with two planes perpendicular to the plane of tangency with the condyles defines: two circles of equal radii RI and R2, these circles having respectively their center points 01 and 02.

The part of the knee lying on the side of the tibia is represented in FIG. 10. The aim is to find the plane of the tibial plateau, this plane being defined by the point C1 of the internal tibial cavity of the prosthesis, by the point C2 of the external tibial hollow. of the prosthesis and the direction of the tibial crest UC, this direction being the axis of symmetry of the tibial plateau of the prosthesis.

The geometric parameters defining this prosthesis can thus be the same as those of the knee model. Thus, the simulation of the displacement of a musculoskeletal system with a prosthesis can be managed in the same way as the simulation of the displacement of a musculoskeletal system without prosthesis. It is possible, during the simulation, to vary the position and orientation parameters of the prosthesis in order to study its effect on the person's walking. Other types of prostheses may be considered, for example fixed posterostabilized plateau prostheses, movable trays single or double mobility, hinged, all with a radius of curvature variable or not depending on the bending angle. We can also model uni compartmental prostheses. When these prostheses can not be modeled by a simple geometric element, one can use a tabulation of the profile of this prosthesis as a function of the flexion of the knee.

The invention can determine the optimal placement of a knee prosthesis in the musculoskeletal system. Such a determination can implement several criteria.

A first criterion is for example the evolution of the distance between the attachment points of the lateral ligaments of the knee. These attachment points can be referenced in the musculoskeletal structure and can be visualized during the simulation. The placement of the prosthesis is optimal when the distance between these attachment points remains constant at each moment of walking. In such a case, one can speak of respect for ligament balance in a walking situation. The distance between the attachment points depends on the position of the prosthesis and the behavior of the foot, the study of this distance makes it possible to position the prosthesis.

A second criterion concerns the position of the point of application of the contact force at the interface between the condyles and the tibia during walking. The force is also distributed over both condyles during walking and the phases where the weight of the body on the ground is greatest when this point of application of the contact force is at the center of the knee. The prosthesis is positioned satisfactorily in the absence of detachment.

The reference position of the tibia with respect to the femur when the leg is in extension and does not support a load can be defined as follows:

the lowest point of the circle of radius R I shown in FIG. 9 is placed in contact with the point C1 shown in FIG. 10. In this situation, the tibia and the femur are vertical.

by rotation about an axis perpendicular to the tibial plateau passing through the point Ci, the femur is rotated until the projection of the axis passing through the points 01 and 02 described with reference to Figure 9 on the plateau Tibial is perpendicular to the direction of the ridge Uc. and the femur is rotated about an axis parallel to the ridge direction Uc and passing through Cl, until the femur is in contact with the tibial plateau at point C3. When simulating the displacement of the locomotor apparatus according to an exemplary implementation of the invention, the movement of the foot can be as already described above. The pelvis can be rotated around its center and undergo three different predefined rotations. The correspondence between the acetabulum and the head of the femur is ensured by the translation of the entire femur and tibia occupying its relative reference position,

Knee flexion is provided by a predefined rotation about the axis of the rolls of radius R1 and R2 defined above.

The flexion of the hip is ensured by a predefined rotation of the leg (tibia more femur) around the horizontal z axis. passing through the center of cotyie.

The correspondence between the center of the part of the ankle on the side of the foot and the center of the part of the ankle on the side of the tibia is ensured by the translation of the pelvis, the femur and the tibia.

The correspondence between the different axes of the ankle (tibial forceps axis and astragalus axis) is ensured by an internal and external rotation of the leg (femur plus tibia) and by adduction / abduction of the leg (femur plus tibia).

The correspondence between the center of the acetabulum and the head of the femur is ensured by a translation of the pelvis.

To perform a partial lateral adjustment of the center of the pelvis to its predefined lateral position in z, a rotation of the assembly formed by the femur, tibia and astragalus around the Henke axis for the lateral position is applied. in z of the head of the femur has a given value, this proportion of the final value taking into account the part of stiffness of rotation around the axis of Henke. The pelvis is then translated so as to ensure correspondence between the femur head and the acetabulum.

Finally, a final lateral adjustment of the center of the pelvis is made at the knee level by movement of the femur around its point of contact with the knee so that the head of the femur has a lateral value z equal to that predefined of the acetabulum. Finally, the coordinates of the basin are adjusted in a horizontal plane. During this adjustment, PC contact point management between the femur and the tibial plateau is performed. This point of contact PC is the point Cl or the point C2 defined above. We look for the point of intersection P1 between the sphere whose center is the point of contact PC and whose radius is equal to the distance between this point of contact and the center of the head of the femur and the vertical axis passing through the center of the pelvic cup. A rotation is then made around the axis perpendicular to the plane defined by the points P1 and PC and by the center of the head of the femur of an angle equal to the angle between the line passing through the points P1 and PC and the line passing through the center of the head of the femur and the point PC. It is then verified that this rotation does not modify the contact point PC by collision detection of the other point C1 or C2 with the tibial plateau.

Other application examples

Simulation of the musculoskeletal system at. the help of the musculoskeletal structure 10 can make it possible to determine the adduction and abduction movements of the musculoskeletal system, the internal and / or external rotational movements of certain parts of the musculoskeletal apparatus and also the quantities mechanical representations of a stress exerted on the bones or the muscles of the person. Determining said quantities can make it possible to correlate the intensity of these quantities with the severity of an age-related pathology, and to develop a model for predicting pathology.

The musculoskeletal structure may for example be used by doctors before or after an operation to prepare this operation or to validate an intervention that has already been performed.

Alternatively, the musculoskeletal system can be simulated using the musculo-squeleitic structure to faithfully represent the musculoskeletal system, for pedagogical purposes, for example during an anatomy course or for a recreational purpose, for example. example to make computer-generated images, for video games, or cartoons.

We can also identify the dynamics of the person using the musculoskeletal structure, according to the third method shown in Figure 7.

For example, during a step 200, a set of forces is applied to the center of gravity of the musculoskeletal structure and its movement is simulated, the kinematic quantities of the lower part of the musculoskeletal structure being for example already known using mini inertial units 7 thanks to kinematic simulation, recaled or not.

By the inverse kinematic technique, the foot forces on the ground are deduced at a step 210, which is compared with a step 220 to the values delivered by ia or the force platforms 8,

Steps 200 to 220 are then repeated, if necessary, by modifying the force values applied to the center of gravity of the structure until, in step 220, similar values are obtained between the measured values and the values from the simulation.

We. can then determine the inter-segmental efforts in the musculoskeletal structure, such efforts being for example the efforts of the segment of the femur on the tibial segment, this effort grouping together the forces due to the tension in the muscles and the contact forces at the cartilage level.

At step 230 the muscular forces are estimated by applying a criterion of distribution among the muscles.

At step 240, the muscle forces are subtracted from the intersegmental forces so as to obtain an estimate of the contact forces.

During a step 250, the musculational structure can be modified by varying at least one of the predefined parameters of the structure, as previously described, in order to refine the model in correlation with the kinematics.

When the device 1 is devoid of an acquisition system, an adaptation of the musculoskeletal structure to the operation of the musculoskeletal system of the person is performed so that the stresses are physiologically acceptable.

It is then possible, in a step 260, to vary the values used during step 200, these values being for example delivered by the force or expected platforms.

During a step 270, it is possible to calculate the voltages and the stresses on the elements of the musculoskeletal structure responsible for the elastic retention or passive moments, along the non-motor axes and to verify that these voltages and stresses remain in acceptable values for the musculoskeletal system.

In the negative, steps 260 and / or 270 are repeated until said voltages and stresses are acceptable to the locomotor apparatus. Steps 260 and 270 may make it possible to give more consistency to the musculoskeletal structure 10, in particular by taking into account the deformability of the cartilages.

The musculoskeletal structure can also, when it has been adapted to the functioning of the musculoskeletal system of the person, to know at each moment of the person's progress, the shape, positions and relative speeds of the person. cartilages, the intensity of the contact forces and the point of action of the contact force, which may make it possible to obtain the pressure fields over time in the joints, in particular in each articulation, of the apparatus locomotor.

A further application of musculoskeletal simulation using the musculoskeletal structure will now be described in detail.

Application to the manufacture of orthoses or prostheses

The device 1 can be arranged to enable a user to introduce, in the course of simulating the movement and / or displacement of the musculoskeletal apparatus using the musculoskeletal structure 10, parameters relating to at least one orthosis and / or a prosthesis. In the example of Figure 5, it is an orthopedic insole 20 carried by the person. These parameters concern, for example in the case of the orthopedic insole, the shape and / or the hardness of which can be modified as described in the application FR 2 844 995.

The introduction of this orthopedic insole may necessitate changes in the sagittal plane of the musculoskeletal structure to maintain the kinetic motion variation similar to that measured without the orthopedic insole.

In the other planes, rules of mechanics and solid contact between the action of the body weight and the reaction of the soil via the soles which are for example considered incompressible can be applied.

At least one of the parameters relating to the sole can be varied by observing, for example by iteration, the effect of this variation on one or more of the mechanical quantities representative of a stress exerted on the cartilages of the bones and / or the muscles of this person in motion. It is possible to converge the value of the parameter (s) relating to the soleplate so as to minimize the one or more mechanical magnitudes. For example, FIG. 6 shows an exemplary method according to the invention for the automatic manufacture of insoles.

In a step 100, using the acquisition system 6 described above, measurements are made during the patient's walk.

In a step 1 10, the musculoskeletal structure described above is adapted to the operation of the patient's locomotor apparatus.

In a step 120, is introduced into the musculoskeletal structure thus adapted parameters relating to at least one orthopedic insole 20.

At step 130, simulates the movement of ^the musculoskeletal system of the patient using the musculoskeletal structure in the presence of or insoles.

At a step 140, one or more of the characteristic quantities mentioned above are observed.

At a step 150, parameter values relating to at least one of the orthopedic insoles are varied.

Steps 140 and 150 may be iterated until parameter values relating to one of the soles 20 minimizing the at least one characteristic magnitude are obtained.

A. step 160, the device can communicate with a computer-aided design system to transmit information to enable it to manufacture one or more orthopedic insoles, this manufacturing taking place at a step 170.

A. step 180, the sole or soles are provided to the person, being for example directly delivered to the latter or sent to it.

The expression "comprising a" shall be understood as meaning "containing at least one" unless the contrary is specified.

Claims

1. A method implemented with a computer system (1 1) for simulating the musculoskeletal system of a person using a virtual musculoskeletal structure (10), the musculoskeletal stmcture (10) s extending cervical to the feet and representing the feet as a deformable joint, input sizes applied to the musculoskeletal structure (10) being modifiable and / or

the musculoskeletal structure (10) being modifiable by acting on predefined parameters, the musculoskeletal structure (10) taking into account:

the movements caused in the sagittal plane during the displacement of the musculoskeletal system and the movements undergone by the skeleton in at least one plane other than the sagittal plane

process in which

- the movement and / or displacement of the musculoskeletal system is simulated using the musculoskeletal structure (10) and,

at least one of the predefined parameters of the musculoskeletal structure (10) and / or at least one of the input quantities applied to the musculoskeletal structure is varied in order to adapt them to the functioning of the musculoskeletal system of said person.

The method of claim 1 wherein the musculoskeletal structure (10) is adapted to the operation of the locomotor apparatus of said person and / or the input quantities applied to said structure (10) by matching values of data associated with a simulation of the musculoskeletal system using said musculoskeletal stmcture (10) and the values of these same data associated with the musculoskeletal system of said person.

3. Method according to the preceding claim, comprising the step of acquiring, in static and moving state, data relating to the musculoskeletal system of the person and / or to at least one input quantity applied to said person. musculoskeletal apparatus and according to which at least one of the parameters is varied predefined musculoskeletal structure (1 0) and / or at least one input quantity applied to said structure to adapt to the functioning of the musculoskeletal system of the person according to the acquired data.

4. Method according to claim 2 or 3, comprising the step of entering data relating to the musculoskeletal system of the person and / or to at least one input quantity applied to said locomotive apparatus in the computer system (1). 1) and according to which at least one of the predefined parameters of the musculoskeletal structure (10) and / or at least one input quantity applied to said structure is varied in order to adapt them to the functioning of the musculoskeletal system. the person according to the data entered.

5. A method according to any one of the preceding claims, wherein predefined parameters of the musculoskeletal structure (10) are related to the shape of the bones.

6. Method according to the preceding claim, wherein parameters relating to the shape of the bones are chosen from bone dimensions and / or values of angles between different parts of a bone or between two adjacent bones, and in which one varies these parameters during the simulation by deforming the bones.

7. A method according to any one of the preceding claims, wherein predefined parameters of the musculoskeletal structure (10) relate to the shape and / or position of the muscle attachments and wherein these parameters are varied during the simulation by deforming and / or moving the muscular attachments.

The method of any one of the preceding claims, wherein predefined parameters of the musculoskeletal structure (10) relate to the size, shape of the cartilages and their position relative to the bones.

9. A method according to any one of the preceding claims, wherein 3e pied is represented in the musculoskeletal structure as an assembly comprising between two and twenty-six articulated bones relative to each other.

10. A method according to any one of the preceding claims, wherein the different planes of the sagittal plane are frontal and transverse planes in which skeletal movements occur under the action of weight, soil reaction and holding moments. liabilities relating to the configurable elastic stiffness of the capsules and ligaments exerted on the joints.

A method as claimed in any one of the preceding claims comprising the step of determining at least one mechanical quantity representative of a stress exerted on the bones, cartilages and / or muscles of that moving person.

12. Method according to

preceding, the mechanical quantity being chosen from:

the amplitude of the internal / external rotation movements of the lower limb,

the contact surfaces of the coxo-femoral joints, - the point of application of the forces on the coxofemoral joints and the distribution of these.

the angle between the femoral condyle axis and the tibial plateau, the rotation of the axis of the femoral condyles relative to the perpendicular to the axis of the tibial plateau,

the distribution of the forces between the two femoral condyles,

velocity, direction, orientation of the peronéo-tibio-astragalian joint,

the contact surfaces between the tibial-fibula joint and the astragalus dome,

- the speed and direction of rolling of the calcaneus with respect to the ground, the angle of rotation of the astragalus with respect to the calcaneus, the elongation of the muscles,

the interaction between the muscles and the bones,

the pressure on the cartilages,

- indicators at each point of rotation and / or rolling.

13. The method of claim 11 or 12, wherein one introduces parameters relating to at least one orthosis and / or a prosthesis (20) carried by the person and, wherein one adjusts the shape and / or the hardness of said orthosis. and / or prosthesis (20) by varying at least one of said parameters relating to the orthosis and / or prosthesis, so as to minimize at least one of the mechanical quantities representative of a stress exerted on the bones and / or the muscles of the person in dynamic regime.

14. Method according to the preceding claim, wherein the orthosis and / or prostheses (20) are automatically manufactured according to the material, the shape and / or its adjusted physical characteristics.

15. The method of claim 3, wherein a data acquisition is performed using sensors (7) carried by the person and / or a force platform (8); and / or a high rate camera and / or a platform for capturing plantar pressure.

16. Method according to any one of the preceding claims, wherein the computer system comprises a screen (3) and in which is displayed on the screen at least one image of the muscuio-skeletal structure (10).