ArticleJournal of neuroengineering and rehabilitation2016
Neuro-musculoskeletal simulation of instrumented contracture and spasticity assessment in children with cerebral palsy.
Article in Journal of neuroengineering and rehabilitation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed.
- Subject-specific muscle properties from diffusion tensor imaging significantly improve the accuracy of musculoskeletal models.Journal of anatomy · 2020Trial
- Trial
- Advancements in Understanding Spasticity: A Neuromusculoskeletal Modeling Perspective.Journal of clinical medicine · 2025Review
- Estimating the contribution of musculoskeletal impairments to altered gait kinematics in children with cerebral palsy using predictive simulations.Journal of neuroengineering and rehabilitation · 2025Article
- Impact of Femoral and Tibial Torsion on Patellofemoral Loading in Individuals With Patellofemoral Instability.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Article
- Biomechanical analysis of hip, knee, and ankle joint contact forces during squats in elite powerlifters.PloS one · 2025Article
- Lower limb joint loading during high-impact activities: implication for bone health.JBMR plus · 2024Article
- Estimation of the forces exerted on the limb long bones of a white rhinoceros (Ceratotherium simum) using musculoskeletal modelling and simulation.Journal of anatomy · 2024Article
- Experiment-guided tuning of muscle-tendon parameters to estimate muscle fiber lengths and passive forces.Scientific reports · 2024Article
- SpasticSim: a synthetic data generation method for upper limb spasticity modelling in neurorehabilitation.Scientific reports · 2024Article
- Identification of Neural and Non-Neural Origins of Joint Hyper-Resistance Based on a Novel Neuromechanical Model.IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society · 2024Article
- A Velocity Stretch Reflex Threshold Based on Muscle-Tendon Unit Peak Acceleration to Detect Possible Occurrences of Spasticity during Gait in Children with Cerebral Palsy.Sensors (Basel, Switzerland) · 2023Article
- Dysfunctional neuro-muscular mechanisms explain gradual gait changes in prodromal spastic paraplegia.Journal of neuroengineering and rehabilitation · 2023Article
- Intra- and inter-subject variability of femoral growth plate stresses in typically developing children and children with cerebral palsy.Frontiers in bioengineering and biotechnology · 2023Article
- Quantitative assessment of spasticity: a narrative review of novel approaches and technologies.Frontiers in neurology · 2023Review
- How mechanics of individual muscle-tendon units define knee and ankle joint function in health and cerebral palsy-a narrative review.Frontiers in bioengineering and biotechnology · 2023Review
- The gait pattern and not the femoral morphology is the main contributor to asymmetric hip joint loading.PloS one · 2023Article
- Multi-level personalization of neuromusculoskeletal models to estimate physiologically plausible knee joint contact forces in children.Biomechanics and modeling in mechanobiology · 2022Article
- Investigation of neural and biomechanical impairments leading to pathological toe and heel gaits using neuromusculoskeletal modelling.The Journal of physiology · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundIncreased resistance in muscles and joints is an important phenomenon in patients with cerebral palsy (CP), and is caused by a combination of neural (e.g. spasticity) and non-neural (e.g. contracture) components. The aim of this study was to simulate instrumented, clinical assessment of the hamstring muscles in CP using a conceptual model of contracture and spasticity, and to determine to what extent contracture can be explained by altered passive muscle stiffness, and spasticity by (purely) velocity-dependent stretch reflex.
methodsInstrumented hamstrings spasticity assessment was performed on 11 children with CP and 9 typically developing children. In this test, the knee was passively stretched at slow and fast speed, and knee angle, applied forces and EMG were measured. A dedicated OpenSim model was created with motion and muscles around the knee only. Contracture was modeled by optimizing the passive muscle stiffness parameters of vasti and hamstrings, based on slow stretch data. Spasticity was modeled using a velocity-dependent feedback controller, with threshold values derived from experimental data and gain values optimized for individual subjects. Forward dynamic simulations were performed to predict muscle behavior during slow and fast passive stretches.
resultsBoth slow and fast stretch data could be successfully simulated by including subject-specific levels of contracture and, for CP fast stretches, spasticity. The RMS errors of predicted knee motion in CP were 1.1 ± 0.9° for slow and 5.9 ± 2.1° for fast stretches. CP hamstrings were found to be stiffer compared with TD, and both hamstrings and vasti were more compliant than the original generic model, except for the CP hamstrings. The purely velocity-dependent spasticity model could predict response during fast passive stretch in terms of predicted knee angle, muscle activity, and fiber length and velocity. Only sustained muscle activity, independent of velocity, was not predicted by our model.
conclusionThe presented individually tunable, conceptual model for contracture and spasticity could explain most of the hamstring muscle behavior during slow and fast passive stretch. Future research should attempt to apply the model to study the effects of spasticity and contracture during dynamic tasks such as gait.
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