High-Fidelity Finite Element Modeling Technique to Improve Sensitivity to Bone Tissue Changes of Older Adults with Obesity undergoing Intensive Lifestyle Intervention

Introduction: Obesity presents a significant health risk for the aging population. Research shows that weight loss and regular exercise can greatly improve the functional status of older adults who are obese. However, weight loss may also result in a decrease in bone mass. To properly assess changes in fracture risk due to lifestyle interventions, a direct biomechanical evaluation of bone strength and fracture risk at metabolically active sites is essential. Methods: Computed tomography scans taken at two different time points of ten human volunteers provided the foundation for this study. A high-fidelity segmentation and modeling approach was taken to generate finite element models. Fracture risk before and after lifestyle intervention was compared using well-established hip and spine fracture models. In this study, two modeling techniques for generating finite element analyses were compared for their ability to detect minor changes in bone strength. Results: An uncertainty analysis of methodologies indicated that a high-fidelity anatomically detailed modeling technique would be more sensitive than state-of-the-art voxel-based techniques to detect changes in bone strength and subsequent fracture risk due to lifestyle intervention. Conclusion: The presented study demonstrated the ability to generate high-fidelity finite element models with unparalleled precision by capturing individual anatomical variations and material properties.