ArticlePLoS computational biology2019
Predicting gait adaptations due to ankle plantarflexor muscle weakness and contracture using physics-based musculoskeletal simulations.
Article in PLoS computational biology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 1 of them a synthesis that pooled it.
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Who cites it
70 citing papers in PubMed, 1 synthesis or guideline pooled it, 184 citations in OpenAlex.
- Telecoaching: a potential new training model for Charcot-Marie-Tooth patients: a systematic review.Frontiers in neurology · 2024Pooled it
- Effectiveness of exercise prehabilitation before anterior cruciate ligament reconstruction on functional outcomes - a single-blinded randomized controlled trial.Scientific reports · 2026Trial
- GaitDynamics: a generative foundation model for analyzing human walking and running.Nature biomedical engineering · 2026Article
- Unified comparison of spinal locomotion control architectures in neuromechanical simulations.bioRxiv : the preprint server for biology · 2026Article
- Modulating reflexes enables speed control in simulated human walking and running.Scientific reports · 2026Article
- Simulation-guided design of exotendons to reduce the energetic cost of running.bioRxiv : the preprint server for biology · 2026Article
- Relationship of lower-limb muscle properties with motor control, walking and balance in stroke survivors.Scientific reports · 2025Article
- A spinal network of proprioceptive reflexes can produce a variety of bipedal gaits.Communications biology · 2025Article
- A model of the cerebellum generates gait adaptations in a reflex-based neuromusculoskeletal model during split-belt walking.Journal of neuroengineering and rehabilitation · 2025Article
- A model of the cerebellum generates gait adaptations in a reflex-based neuromusculoskeletal model during split-belt walking.bioRxiv : the preprint server for biology · 2025Article
- Mechanisms of adaptive interlimb coordination to sudden ground loss: a neuromusculoskeletal modeling study.bioRxiv : the preprint server for biology · 2025Article
- Estimating the contribution of musculoskeletal impairments to altered gait kinematics in children with cerebral palsy using predictive simulations.Journal of neuroengineering and rehabilitation · 2025Article
- A physiologically inspired hybrid CPG/Reflex controller for cycling simulations that generalizes to walking.PLoS computational biology · 2025Article
- An accuracy assessment of SlicerAutoscoperJournal of biomechanics · 2025Article
- A PRISMA systematic review through time on predictive musculoskeletal simulations.Journal of neuroengineering and rehabilitation · 2025Article
- The Neuromusculoskeletal Modeling Pipeline: MATLAB-based model personalization and treatment optimization functionality for OpenSim.Journal of neuroengineering and rehabilitation · 2025Article
- Muscle weakness but also contractures contribute to the progressive gait pathology in children with Duchenne muscular dystrophy: a simulation study.Journal of neuroengineering and rehabilitation · 2025Article
- Active Arm Swing During Running Improves Rotational Stability of the Upper Body and Metabolic Energy Efficiency.Annals of biomedical engineering · 2025Article
- How knee muscles and ground reaction forces shape knee buckling and ankle push-off in neuromuscular simulations of human walking.Scientific reports · 2025Article
- Perturbation-based estimation of within-stride cycle metabolic cost.Journal of neuroengineering and rehabilitation · 2024Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
Deficits in the ankle plantarflexor muscles, such as weakness and contracture, occur commonly in conditions such as cerebral palsy, stroke, muscular dystrophy, Charcot-Marie-Tooth disease, and sarcopenia. While these deficits likely contribute to observed gait pathologies, determining cause-effect relationships is difficult due to the often co-occurring biomechanical and neural deficits. To elucidate the effects of weakness and contracture, we systematically introduced isolated deficits into a musculoskeletal model and generated simulations of walking to predict gait adaptations due to these deficits. We trained a planar model containing 9 degrees of freedom and 18 musculotendon actuators to walk using a custom optimization framework through which we imposed simple objectives, such as minimizing cost of transport while avoiding falling and injury, and maintaining head stability. We first generated gaits at prescribed speeds between 0.50 m/s and 2.00 m/s that reproduced experimentally observed kinematic, kinetic, and metabolic trends for walking. We then generated a gait at self-selected walking speed; quantitative comparisons between our simulation and experimental data for joint angles, joint moments, and ground reaction forces showed root-mean-squared errors of less than 1.6 standard deviations and normalized cross-correlations above 0.8 except for knee joint moment trajectories. Finally, we applied mild, moderate, and severe levels of muscle weakness or contracture to either the soleus (SOL) or gastrocnemius (GAS) or both of these major plantarflexors (PF) and retrained the model to walk at a self-selected speed. The model was robust to all deficits, finding a stable gait in all cases. Severe PF weakness caused the model to adopt a slower, "heel-walking" gait. Severe contracture of only SOL or both PF yielded similar results: the model adopted a "toe-walking" gait with excessive hip and knee flexion during stance. These results highlight how plantarflexor weakness and contracture may contribute to observed gait patterns.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.