A preliminary Musculoskeletal modeling

Approach for handwriting

T. REZGUI¹,2, R. Hayder2, S. Mlawah2, C. Ayari2, I. Chihi1,3,4

1
Applied Mechanics and Systems Research Laboratory (LASMAP), Tunisia Polytechnic
School, University of Carthage, Tunis, Tunisia
Email address: Tayssir.rezgui@enib.u-carthage.tn
2
National Engineering School of Bizerta, University of Carthage, Tunis, Tunisia
3
Laboratory of energy applications and renewable energy efficiency (LAPER), Faculty of
Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
4
Deptartement of Engineering, The Faculty of Science, Technology and Medicine, University
of Luxembourg, Kirschberg, Luxembourg

Abstract. Robotic prosthetic limbs are considered as a powerful solution ensuring

daily life autonomy of amputees when it replace mechanical function of lost ex-
tremities and partially restore capacity of moving. Handwriting is an important ac-
tivity of daily living, there are no prostheses specially dedicated to writing. Be-
cause of its very fine motions, the understanding of the motion coordination as
well as the quantification of required grip pen’s force and involved muscle forces
will provide a range of useful movements for the user and the improve the choice
of the actuation’s systems to meet the need to have a smooth and very intuitive
handwriting movement prediction for the user. To achieve this, musculoskeletal
modeling seems to be an interesting approach. The aim of this study was to build a
primary complete musculoskeletal model of the hand to examine muscular coordi-
nation for finger flexion and grip pen tasks. Our hand model is developed based
on OpenSim’s wrist model. To meet handwriting needs, the hand and forearm
were modeled as kinematic chains of 23 rigid with 22 degrees of freedom, in
which all phalange segments and joints (5 proximal, 4 medial and 5 distal phalan-
ges) were introduced. Anatomical bone segment and muscle morphological pa-
rameters were updated to fit recent published data. This study allows to examine
muscular coordination through muscle lengthening / shortening and net joint mo-
ment information for a simple given finger kinematics. To validate model’s re-
sults, precise hand’s kinematics from motion capture technics, muscle activation
from electromyography systems and grip pen’s force from sensors are required for
comparison studies.

Keywords: Handwriting, Musculoskeletal Modeling, OpenSim

2 T. REZGUI, R. Hayder, S. Mlawah, C. Ayari, I. Chihi

1 Introduction

Losing the ability to fully control the upper limb, either because of amputation
or paralysis, has a profound effect on the activities of daily life. In the last dec-
ades, assistive robots and prostheses have been considered as an important re-
search field aiming to allow people with disabilities to regain functions (Cordella
et al, 2016; Adewuyi et al, 2017; Mastinu et al, 2018); Robotic prosthetic limbs
are considered as a powerful solution ensuring daily life autonomy of amputees
when it replace mechanical function of lost extremities and restore capacity of
moving and interacting with the environment.
However, due to the anatomical and physiological complexity of the human
hand, fully replicating all its functions in a natural and autonomous way, has prov-
en to be highly challenging, especially for complex movements and fine motor
skills like handwriting.
Indeed, handwriting is considered a physical manifestation of a complex cogni-
tive process that can be used to characterize a person and express her social, aca-
demic level, intellectual component, and even the psycho-physical personality of
the writer, the temperamental tendencies and psychic state, etc. (Viviani, 1983).
Writing is produced through motions of the upper limb that can be represented by
forearm muscular activities, named Electromyographic signals (EMG), we hy-
pothesize that EMG driven models can allow reconstruction of an individual
handwriting.
In handwriting case, myoelectric prosthesis can be considered as a manipulator
designed to move a pen through the muscular contractions generated by the user to
set himself in motion and picked from electrodes attached in the socket of the
prosthesis are in direct contact with the skin (Kamavuako et al, 2013; Chihi et al,
2016; Chihi et al, 2017; Clement et al, 2011, Okorokova et al, 2015; Lebedev et al,
2020).
Even if handwriting is an important activity of daily living, which requires sen-
sorimotor and cognitive skills to generate a very fine motions, there are no pros-
theses specially dedicated to writing. As the main goal is to generate smooth and
precise handwriting movement from recorded forearm muscles activities using
surface electrodes and ensure handwriting quality and efficiency to best meet us-
er’s needs in everyday life, the development of such prosthesis is still a challenge.
The understanding of the coordination of the fine movements of the hand, as well
as the motor skills are necessary for the comprehension of pathologies, as well as
the development of tools to help autonomy such as prostheses of the hand or ro-
bots with more refined skills. Musculoskeletal modeling seems to be an interesting
approach to achieve this.
A preliminary Musculoskeletal modeling Approach for handwriting 3

Several musculoskeletal models of the hand were developed to enhance under-

standing hand kinematics and surrounding muscle coordination for pathology’s
diagnostics and rehabilitation or (performing efficient industrial tasks (Gonzalez et
al. 1997, Holzbaur et al. 2005, Vignais et Marin. 2014, Hansen et al. 2018,
Mirakhorlo 2018), with varied degrees of freedom (15-24 DoF) and number of
modeled muscles (15-50 muscles). Some developed generic models (Gonzalez et
al. 1997, Holzbaur et al. 2005, Vignais et Marin. 2014) and more recently subject-
specific musculoskeletal models based on imaging data were introduced (Marin et
al 2018, Mirakhorlo 2018). Despite this interest on understanding hand motions,
no studies were interested on handwriting activity.
In order to understand finger kinematics and muscle coordination during hand-
writing as necessary in developing a writing prosthesis providing smooth and very
intuitive movement prediction for the user, the aim of this study was to build a
primary complete musculoskeletal model of the hand to examine muscular coordi-
nation for a given finger kinematics (grasping pen) using Opensim 4.0.

2 Musculoskeletal model of the hand

In this study, OpenSim software was used as a promising tool for physics-based
modeling and simulation of biological structures to estimate the non-measurable
internal forces, the muscular and articular forces through inverse dynamics meth-
od and the optimization tools (Delp et al.2007).
Our hand model is developed based on OpenSim’s wrist model, developed by
Gonzalez et al. 1997, designed for the study of wrist flexion-extension. The wrist
model is composed of the bony structures of the including the hand and wrist
segments: humerus, ulna, radius, carpals, metacarpals and fingers which are repre-
sented by a single rigid segment each. In this model, the humerus is fixed, the el-
bow and wrist have 3ddl, the index finger and thumb each have four degrees of
freedom at the index finger are abduction and metacarpophalangeal flexion. The
carpometacarpal and interphalangeal joints remained at full extension during wrist
flexion extension. The model is actuated by 15 muscles of the forearm and hand
(Gonzalez et al. 1997).
To meet handwriting needs, the anatomical structures of the hand and forearm
were modeled as kinematic chains of 23 rigid segments in which the bony struc-
tures of the different fingers (thumb (I), index finger (II), middle finger (III), ring
finger (IV) and little finger (V) were introduced with 5 proximal, 4 medial and 5
distal phalanges (figure 1). We have included a total of 22 degrees of freedom of
the hand. Indeed, the humerus is fixed and the elbow joint is blocked. Only the
wrist flexion-extension movement is allowed. The MCP joints have two degrees
of freedom, allowing flexion-extension and abduction-adduction. The proximal
(PIP) and distal (DIP) interphalangeal joints have one degree of freedom (flexion-
extension). The carpo-metacarpal joint (CMC) of the thumb has two degrees of
4 T. REZGUI, R. Hayder, S. Mlawah, C. Ayari, I. Chihi

freedom (flexion-extension and abduction-adduction). In accordance with the in-

dex finger joints, the maximum angular limits of movement of interphalangeal
joints were fixed.

Fig 1. Bone segments of the hand and forearm Model

In this preliminary model, we opted to conserve the same set of muscle of the
forearm and hand, as represented in Gonzalez et al. 1997: Extensor indicis (EI),
Extensor carpi radialis longus (ECRL), Extensor digitorum (ED), Extensor carpi
radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Flexor digitorum superfi-
cialis (FDS), Flexor digitorum profundus (FDP), Flexor carpi radialis (FCR),
Flexor carpi ulnaris (FCU), Adductor Pollicis Longus (APL), Extensor Pollicis
Longus (EPL), Extensor Pollicis brevis (EPB), Flexor Pollicis Longus (FPL), and
Palmaris Longus (PL). A total of 25 muscle–tendon actuator was modelled as
Zajac-type muscle based on musculotendon parameters from force-velocity-length
relationships (Thelen et al. 2006).
Bone masses and inertias, joint axis positions and orientations and muscle mor-
phological parameters (PCSA, mass, optimal fiber length and tendon length) were
updated to fit recent published data (Mirakhorlo et al. 2016).
As the used geometric model is generic in terms of dimensions, it is important
to scale automatically different dimensional and inertial properties of the bone
structures from a subject's size and weight to adapt this model to the different sub-
jects. Thus, a set of anatomical markers on each bone phalanges extremities was
added to this model. These markers will also be used for the kinematic analysis of
a movement from capture motion data.
To test our developed model, we realized a voluntary movement of flexion of
the phalanges II to IV (figure 2) and then gripping a pencil as primary task for
handwriting (Figure 3).
A preliminary Musculoskeletal modeling Approach for handwriting 5

Fig. 2. Kinematic study case: Maximum flexion of phalanges II to IV

For gripping a pencil, approximative angular kinematics of index phalange and

thumb were extracted from captured videos using Kinovea software, the other
phalanges were supposed to behave maximum flexion (Figure 3).

Fig. 3. Example of image/video analysis for the handwriting kinematics: (a) Image capture
for grip pencil position (b) anatomical markers for kinematic reconstruction (c)Angular
kinematic during grip pencil position

Net joint moments and muscle lengthening were computed using inverse Dy-
namics and static optimization tools.

3. Musculoskeletal model Results

For a voluntary total flexion of phalanges, Figure 4 presents the evolution of

the muscle elongations. We can observe during this motion, phalanges flexors
have undergone a shortening. Flexor digitorum superficialis shown between 6% -
8% of shortening. However, and Flexor digitorum profundus shown a max of
shortening of 6%. In other side, the extensor digitorum EDM tend to extend fore-
6 T. REZGUI, R. Hayder, S. Mlawah, C. Ayari, I. Chihi

arm with an additional lengthening of 6% and then extensor digitorum-tendon, re-

lated to phalanges: EDCL (V), EDCR (IV), EDCM(III) and EDCI (II) et EDM (I)
were also lengthening with a maximum of 3.5%. other muscular lengths remain
unchanged. These results were accurate to anatomical behavior of muscle.
In our case of study, as we realized a voluntary movement of flexion of the
phalanges, there are no external efforts applied to the hand. Thus, the Inverse Dy-
namics method can estimate the joint moments which represent the muscular con-
tribution around the joint during this task. Figure 5 showed the evolution of the
flexion-extension joint moments of the phalanges during the maximum flexion
movement of phalanges.

Fig. 4. Muscle lengthening during maximum flexion of phalanges

Fig.5. Net Moment of proximal phalanges joints during maximum phalange flexion

For grip pen position, we observed a lengthened extensors muscle of thumb and
index finger and shortened flexors ones (figure 6). However, the Adductor Pollicis
Longus (APL) and the Flexor Pollicis Longus (FPL) observed the important
amount of variation, respectively +15 % and -18 %.
A preliminary Musculoskeletal modeling Approach for handwriting 7

Fig. 6. Muscle lengthening during Pen gripping

5 Conclusion

The understanding of the coordination of the fine movements during handwrit-

ing is important to enhance the development of tools to help autonomy of handi-
cap patients. As musculoskeletal modeling seems to be an interesting approach,
the aim of this study was to build a primarily musculoskeletal model of the hand
and wrist using Opensim software and introducing all phalanges degree of free-
dom and updating anatomical data from recent publications. This study allows to
examine muscular coordination through muscle lengthening / shortening and net
joint moment information for a simple given finger kinematics (maximum flexion
of fingers and pen gripping tasks). To validate model’s results, precise hand’s kin-
ematics from motion capture technics, muscle activation from electromyography
systems and grip pen’s force from sensors are required for comparison studies.
These results will provide an indication of model validity for use in estimating
muscle forces during specific hand tasks. For developing writing prosthetic devic-
es, the quantification of required grip pen’s force and involved muscle forces will
provide a range of useful movements for the user and the improve the choice of
the actuation’s systems to avoid inappropriate muscle force production in the fin-
gers and then meet the need to have a smooth and very intuitive movement predic-
tion for the user.
8 T. REZGUI, R. Hayder, S. Mlawah, C. Ayari, I. Chihi

Acknowledgements

The authors also gratefully acknowledge the helpful comments and suggestions
of the reviewers, which have improved the presentation.

References

Mastinu E, Ahlberg J, Lendaro E, Hermansson L, Håkansson B, Ortiz-Catalan M. An Al-

ternative Myoelectric Pattern Recognition Approach for the Control of Hand Prostheses:
A Case Study of Use in Daily Life by a Dysmelia Subject. IEEE Journal of Translation-
al Engineering in Health and Medicine, vol. 6, pp. 2168-2372, 2018.
Adewuyi AA, Hargrove LJ, Kuiken TA. Resolving the effect of wrist position on myoelec-
tric pattern recognition control. J Neuroeng Rehabil, vol. 1, pp.14-39, 2017
Cordella F, Ciancio AL, Sacchetti R, Davalli A, Cutti AG, Guglielmelli E, Zollo L. Litera-
ture review on needs of upper limb prosthesis users. Front Neurosci, vol.10, pp.
197:209, 2016.
Viviani P, Terzuolo CA, The organization of movement in handwriting and typing. Lang
Prod 2:103–146, 1983.
Kamavuako, E. N., Rosenvang, J. C., Bøg, M. F., Smidstrup, A., Erkocevic, E., Niemeier,
M.J., Jensen W., and Farina, D. (2013) 'Influence of the feature space on the estimation
of hand grasping force from intramuscular EMG', Biomed. Signal Process. Control, 1:1–
5. https://doi.org/10.1016/j.bspc.2012.05.002
Chihi, I., Abdelkrim, A. and Benrejeb, M. (2016), Multi-model approach to characterize
human handwriting motion, Biological Cybernetics, Springer, 1: 17–30. DOI:
10.1007/s00422-015-0670-6
Chihi, I., Abdelkrim, A. and Benrejeb, M. (2017)'Internal Model Control to Characterize
Human Handwriting Motion', Arab Journal of Applied Sciences, 14,6: 861-869.
Clement R.G.E., Bugler K.E. and Oliver C.W. (2011), Bionic prosthetic hands: A review of
present technology and future aspirations, The Surgeon, 6:336-340. DOI:
10.1016/j.surge.2011.06.001
Okorokova E, M. Lebedev, M. Lindermann, A. Ossadtchi, A dynamical model improves
reconstruction of handwriting from multichannel electromyographic recordings. Fron-
tiers in Neuroscience. Vol. 9, No. 389, pp. 1-15, 2015.
Lebedev M., A. Ossadtchi, E. Okorokova, J. Erlichman, V. Rupasov, M. Linderman, Gen-
erating Handwriting from Multichannel Electromyographic Activity, Brain--Computer
Interface Research: A State-of-the-Art Summary 8, Springer International Publishing,
pp. 11--23, 2020.
Gonzalez, R. V., Buchanan T. S., and Delp S. L (1997) How muscle architecture and mo-
ment arms affect wrist flexion-extension moments. J. Biomech. 30:705–712. DOI:
10.1016/s0021-9290(97)00015-8
Holzbaur, K. R. S., Murray, W. M., Delp, S. L. (2005). A Model of the Upper Extremity for
Simulating Musculoskeletal Surgery and Analyzing Neuromuscular Control. Annals of
Biomedical Engineering, 33(6), 829–840. doi:10.1007/s10439-005-3320-7
Vignais N, Marin F. 2014. Analysis of the musculoskeletal system of the hand and forearm
during a cylinder grasping task. Int J Ind Ergon. 44:535–543. DOI:
10.1016/j.ergon.2014.03.006
A preliminary Musculoskeletal modeling Approach for handwriting 9

Hansen C, Gosselin F, Ben Mansour K, Devos P, Marin F. 2018. Design validation of a

hand exoskeleton using musculoskeletal modeling. Appl Ergon.68:283–288.
http://dx.doi.org/10.1016/j.apergo.2017.11.015
Mirakhorlo M, Van Beek N, Wesseling M, Maas H, Veeger H. E. J., Jonkers I (2018) A
musculoskeletal model of the hand and wrist: model definition and evaluation, Comput-
er Methods in Biomechanics and Biomedical Engineering, 21:9, 548-557, DOI:
10.1080/10255842.2018.1490952
Marin F, Devos P, Hansen C, Charleux F, Robert L , Ben Mansour K (2018): Subject spe-
cific hand and forearm musculoskeletal 3D geometries using high-resolution MR imag-
es, Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visu-
alization, DOI: 10.1080/21681163.2018.1434422
Mirakhorlo M, Visser JM, Goislard de Monsabert B, van der Helm F, Maas H, Veeger H.
2016. Anatomical parameters for musculoskeletal modeling of the hand and wrist. Int
Biomech. 3:40–49. https://doi.org/10.1080/10255842.2018.1490952
Thelen D. G., Anderson F.C., Using computed muscle control to generate forward dynamic
simulations of human walking from experimental data, Journal of Biomechanics, 2006;
39:1107–1115
Delp SL, Anderson FC, Arnold AS, Loan P, Habib A, John CT, Guendelman E, Thelen
DG. 2007. OpenSim: opensource software to create and analyze dynamic simulations of
movement. IEEE Trans Biomedical Eng. 54:1940–1950. DOI:
10.1109/TBME.2007.901024