Physics-Based Simulations to Predict the Differential Effects of Motor Control and Musculoskeletal Deficits on Gait Dysfunction in Cerebral Palsy: A Retrospective Case Study

Frontiers in Human Neuroscience
Antoine FalisseIlse Jonkers

Abstract

Physics-based simulations of walking have the theoretical potential to support clinical decision-making by predicting the functional outcome of treatments in terms of walking performance. Yet before using such simulations in clinical practice, their ability to identify the main treatment targets in specific patients needs to be demonstrated. In this study, we generated predictive simulations of walking with a medical imaging based neuro-musculoskeletal model of a child with cerebral palsy presenting crouch gait. We explored the influence of altered muscle-tendon properties, reduced neuromuscular control complexity, and spasticity on gait dysfunction in terms of joint kinematics, kinetics, muscle activity, and metabolic cost of transport. We modeled altered muscle-tendon properties by personalizing Hill-type muscle-tendon parameters based on data collected during functional movements, simpler neuromuscular control by reducing the number of independent muscle synergies, and spasticity through delayed muscle activity feedback from muscle force and force rate. Our simulations revealed that, in the presence of aberrant musculoskeletal geometries, altered muscle-tendon properties rather than reduced neuromuscular control complexity a...Continue Reading

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Citations

Jul 16, 2020·Journal of Neurophysiology·G CappelliniY Ivanenko
Sep 26, 2020·Frontiers in Bioengineering and Biotechnology·Germana CappelliniYury Ivanenko
Dec 22, 2020·Frontiers in Computational Neuroscience·Di AoBenjamin J Fregly
Jan 14, 2021·Journal of the Royal Society, Interface·Jeroen AelesFrançois Hug
Jan 31, 2021·Journal of Biomechanics·Luca Modenese, Jean-Baptiste Renault
Dec 29, 2020·Frontiers in Neurology·Germana CappelliniYury Ivanenko
Aug 12, 2021·Integrative Organismal Biology·P J BishopJ R Hutchinson
Nov 3, 2021·Scientific Reports·Gilmar F SantosChristof Hurschler

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Software Mentioned

IPOPT
OpenSim
Mimics
MATLAB

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