Predictive simulations identify potential neuromuscular contributors to idiopathic toe walking.

Autor: Veerkamp K; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical & Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University Gold Coast, Australia. Electronic address: k.veerkamp@amsterdamumc.nl., van der Krogt MM; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands., Waterval NFJ; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; Amsterdam UMC, Univ of Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands., Geijtenbeek T; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands., Walsh HPJ; Griffith Centre of Biomedical & Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University Gold Coast, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Australia., Harlaar J; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands; Department of Orthopedics & Sports Medicine, Erasmus Medical Center, Rotterdam, the Netherlands., Buizer AI; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; Emma Children's Hospital Amsterdam UMC, Amsterdam, the Netherlands., Lloyd DG; School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical & Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University Gold Coast, Australia., Carty CP; School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical & Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University Gold Coast, Australia; Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Australia.
Jazyk: angličtina
Zdroj: Clinical biomechanics (Bristol, Avon) [Clin Biomech (Bristol, Avon)] 2024 Jan; Vol. 111, pp. 106152. Date of Electronic Publication: 2023 Dec 10.
DOI: 10.1016/j.clinbiomech.2023.106152
Abstrakt: Background: Most cases of toe walking in children are idiopathic. We used pathology-specific neuromusculoskeletal predictive simulations to identify potential underlying neural and muscular mechanisms contributing to idiopathic toe walking.
Methods: A musculotendon contracture was added to the ankle plantarflexors of a generic musculoskeletal model to represent a pathology-specific contracture model, matching the reduced ankle dorsiflexion range-of-motion in a cohort of children with idiopathic toe walking. This model was employed in a forward dynamic simulation controlled by reflexes and supraspinal drive, governed by a multi-objective cost function to predict gait patterns with the contracture model. We validated the predicted gait using experimental gait data from children with idiopathic toe walking with ankle contracture, by calculating the root mean square errors averaged over all biomechanical variables.
Findings: A predictive simulation with the pathology-specific model with contracture approached experimental ITW data (root mean square error = 1.37SD). Gastrocnemius activation was doubled from typical gait simulations, but lacked a peak in early stance as present in electromyography. This synthesised idiopathic toe walking was more costly for all cost function criteria than typical gait simulation. Also, it employed a different neural control strategy, with increased length- and velocity-based reflex gains to the plantarflexors in early stance and swing than typical gait simulations.
Interpretation: The simulations provide insights into how a musculotendon contracture combined with altered neural control could contribute to idiopathic toe walking. Insights into these neuromuscular mechanisms could guide future computational and experimental studies to gain improved insight into the cause of idiopathic toe walking.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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