Predicting Free Achilles Tendon Strain From Motion Capture Data Using Artificial Intelligence.

The Achilles tendon (AT) is sensitive to mechanical loading, with appropriate strain improving tissue mechanical and material properties. Estimating free AT strain is currently possible through personalized neuromusculoskeletal (NMSK) modeling; however, this approach is time-consuming and requires extensive laboratory data. To enable in-field assessments, we developed an artificial intelligence (AI) workflow to predict free AT strain during running from motion capture data. Ten keypoints commonly used in pose estimation algorithms (e.g., OpenPose) were synthesized from motion capture data and noise was added to represent real-world data obtained using video cameras. Two AI workflows were compared: (1) a Long Short-Term Memory (LSTM) neural network that predicted free AT strain directly (called LSTM only workflow); and (2) an LSTM neural network that predicted AT force which was subsequently converted to free AT strain using a personalized force-strain curve (called LSTM+ workflow). AI models were trained and evaluated using estimates of free AT strain obtained from a validated NMSK model with personalized AT force-strain curve. The effect of using different input features (position, velocity, and acceleration of keypoints, height and mass) on free AT strain predictions was also assessed. The LSTM+ workflow significantly improved the predictions of free AT strain compared to the LSTM only workflow (p < 0.001). The best free AT strain predictions were obtained using positions and velocities of keypoints as well as the height and mass of the participants as input, with average time-series root mean square error (RMSE) of 1.72±0.95% strain and r2 of 0.92±0.10, and peak strain RMSE of 2.20% and r2 of 0.54. In conclusion, we showed feasibility of predicting accurate free AT strain during running using low fidelity pose estimation data.